HomeMy WebLinkAbout630 17TH ST - Building PermitsOWNER
JOB ADDR
PROP. SWR. L�NE Lf NOUSE CON. U
SPRINKLING $�STEM
MISCELlANE0U5
ROUGM HEATING ANO FIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROl1Ntl ❑ POWER �
ROUGH WIRING
TRENCHES FORMS � STEEL RE
FLOOR SYSTEM
60N0 BEAM [] STEEL REINFORCE [
SHEATHING
FRAME AND FLASHING
LATHING - IN � OUT n
PL "TER, 6ROWN COAT
5 fURAL, FINAL
HEniING. VENT.. REFRIG. AND A.C.. FI
DATE 1_g_6g -
SUBCONTRACTOR
IT
6`NNER• MpR �RFST CORP. / DATE 2_3_56 "
JOBADDRESS (�'�O W, 1%th St-. BUILDINGPERMITNO. 232J �
C� �'ERAL CONTRACTOR N3I'RICO. Ii1C, VALUE $ ZOO.00 '
- o moun mac nes
�oT AP 116-200-Lt BLOCK TRACT electric panel '
GROUP J TYPE III ZOIYE �. FIRE DISTRICT 2357
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
_ DATE I Nl1MBER
Wiri
Trench
�ion Forms antl Grade to
Final
St.
;' : Tank or Cesspool
La.�ifng, In Out
Plumbing, Final Gas
Wirinq. Final
Occupancy I I I I -
�: ,,..., �i n r_u i snn i_ss
OWNER MAR CREST CORP, / DATE Q_Q_K(�
JOBADDRESS 63o w, 1%},tl-St.. BUILDINGPERMITNO. �325
G�`�ERALCONTRACTOR Narmco VAWE $. lnn_nn -
LOT A`P 116-200-1� BLOCK TRACT G+�.•��e pf �q ��' �}el,�&�
GROUP J TYPE III ZONE j� FIRE D13TRICT �'�K(�
INSPECTIONS
Footing Trench
Foundation Forms and Gr�de to
Rough Framing _
Plumbing, Rough to Slab
Plumbina. Rouuh Complete
Heating, Final
Sewer, House Sewer, St.
8 : Tank or Cesspool
Le_..mg, In 4ut
Plastering
Plumbing, Final, Fixtures Complete
Wirinq. Final
PERMITS ISSUED
DATE SUBCONTRACTOR
DATE � NUMBER
��'�'��ti�,,� �T � � �
OWNER pprr�Tr uenm rrr�m
JOB ADDRESS .(��p wPc+ 17tt
GENERAL CONT ACTOR
AP t�o. LOT
IN��.; �:TIONS
sa'r-=
.s
WaTEA
��AOUGN PLUMBING
�PAOP. SWA. LINE � NOUSE CON.
�SPRINKLING SVSTEM
MiSCELL�NE0U5
�ROUGM ME�TING �NO AIR CONOITION�NG
TEMPON�RY $ERYICE OA POLE
UN�ERGROUND Q POwER �
ROUGM WIRING
TRENCHES FORMS U STEE4 RE
FLOOR SVSiEM
BONO 9E�M [ j STEEL REINFORCE (
SHE�tMING
FR�ME 1N� FL�SNING
STP'•'T
ME
PLUMtlI
ELECTR
- IX 1 I VVI I I
9, BPOWN CO�T
UA�L. FIN�L
I. VENT.. NE�RIG. �NO �.C.
NG, FIN�L �ND WS TEST �
FIH�L
DATE
SUBCONTRACTOR
I
,i
�_` �
PNOIECTADONESS: 63O W 17TH ST
owxes•seame: NOECKER FAMILY TRUST
��OOflES$:�15054 OXNARD ST
� VAN NUYS
CA 91411
pflLH/ENGINEEfl: � z S 3% 8 7 3—� 16 6
ADOflESS:
HEC.NO.:
UNIT:
UNIT:
PEflMIiTEE: GREG KING ( 714 ) 539-1317
aooeess: S 0 5 3 LARSON AV C
GARDEN GROVE CA 92644
LILENSED CONTBACTOP DFCLANATION: I nere0y ailirm inat I am licensea unaer o�ovis�ons ol CNpter 9lcommencin0 w��� Section
7000� ol Oivision 3 0l t�e Business ana Pmlessions COUe, an0 my license is in IuA brce ana ellect.
CRY LIC.: STQE LIL.: CIASS:
Dale: Signature:
�WOXHEBS' COMPENSATION DFCIAflRTION: I here0y allirm Rut I �ave a certilica�e o� coiaem to sell-insure or a cenilicale of Workers'
Compensalion Insuran[e. or a certilietl copy I�ereol (5¢ciion J800. LaG. C).
IPOLICV NO.: EI(P. DRTE:
COMPANY:
❑ Ceniliee mpy is hereby lumis�ea. ❑ CeNIieE copy is filetl wit� t�e cily BuilEing Oivision.
Dale: l+ppticant:
EXEMFfIONFHOMWONNENS'COMPENSATIOXOELUflATION: �Tti55eClimneMmlhecompkl¢dilNepertol6�aonelWnOretl�5100�ar1e55�.
I certity Iha� in ��e Oedormance a� Ihe vrork tOr wtfitA Ihis p¢rmit i5 i55ue0. I Stwtl no� emp0y any Derson in any mann¢r 5o a5I0 G¢tame
SUUlec1 la ��e Workers' Compen5ation Laws ot Calilamia.
Date: Siqruture:
NOTICE: If. alier maMing Inis aeGdration, you sIWuIE befAme su0jett to ihe Workers' fAmpensatbn provi5ions of the Lahor
Cotle. you mus� lotl�wilh tOmDly wi�h Suc� provisi0n5 Or Ittis permii S�all Ge deemeU r¢voketl.
CONSTPULTION LENOINC AGENLV: I hereGy al�irm I�ai I�ere i5 a canslruCtion IenGing agency lOr I�e pehorman[¢ ol Ihe wnA for
wnicn tnis permit is issue0 (Sectiw 3097, Civ. q.
LENOEfl:
A�UNE$$:
OWNEB BWLOEB OELLAMTION: I �ere0y alfirm inat I am exempt imm t�e Comraclors' State Lkerise Law lor t�e tollowinq reason
�Sectmn 7031.5 Busineu an0 Protesvonal CoCe: My ury of county wtuc� repuires a permit to cansimcl, alter, improve, Aemolish, or
reoait any slmctWe. prior to iis issuance, also Rquires tlle aooliWnt tor sutn Dermit to lile a sipnea statement tAal nelsne is licensea
Dursuam to the pmvisions ol i�e Comractars' State license Law (CtuD�er 9(wmmencinq xit� Section 7000� ol Division 7 0l ��e Busineu
ana Pmlessions COGe) or rtWl n¢/sne 4 e�empt tAeretmm intl tlre Oa5i5 for tAe dllepe0 eaempti0n. My vloldlian ol Setlbn 7031.5 ey
ny applicant lor a oermit su01��s tAe aDd�wnt to a cWil ce�alty oi noi moa tlwn Iive nunareA tlollars (55001.
I, as owner ol Ihe propeny or rty emqoyees vril� wages �s t�eir sole compe�auon, wiu Uo tne vrork. anE �he
� U stmcture ¢ not imen0etl or o�ferea fo� sale �Seclion 70aa. 6usiness an0 Pmfessional COEe: The Coniractors' SWte License Law
does nol appry to an ovmer ol a D�aDeny wiro OuilOs w imprwes ttlereon, an0 wlio Goes SucM1 work Ilimsell/1lersell or Ihrouq�
nis or nei ovm employees, prwiGM inat such improvement5 a2 not intenUeO o� olhrM lor ule. II, Iwwever I�e CuilUinp or
�� imD�ovemem is sda within one year at completiw, ihe owner will luve ine hurtlen ol provinp ne/sne dia nat �uilA or imorove
lor Ine ouroase al Salel.
I. as owner ol t�e pwpeny. am ertluvvely contrac6nA w+�h Ikensetl mniraciors to constmcl the D�ole�� (Section 70aa, Bus�ness
❑ anC Prolessions Cotle: T�e Convactors State License Law Eces not aDdY to an owner of properry wM UunUs or improves t�eaan
antl who comracis for suc� prqttro xit� a contacim�s) license W��� �o t�e Contractws' Sute Lkense Law�. I am aware
I�al prool ol I�eir Workei 5 COmp¢n5dli0n "ulsurdnt¢ 51Wu10 Gt OrOviGM Ia me.
� i am aemot uneer seciron: H P 70 4 4 B. B P. C.
mrmisreaso�; ALL WORR BY OWNER�
i .
�ate: �� �—�T9 / Q�mer.
I tlo nere�y teniiy Ihat I am aware ol ana unUerslan0 ihe reauiremenls ol California Healln and Salety CaOe 5 c�ions T5505, 25533, ane
2553< and Ihal I ot any Iuiure ouil0ing OCtupdnt wiNwin not (citde Me) ne¢a to Compty with SaiC sbte wOes ana ine leauiremenls lor a
Oermi� lor wnsimction ot rtwGifiwtmn imm t�e Air OuaAry Management D¢iricl. HesiEentlal consimciian apD�ications are eeem0� ��om
IheSe Novisions. �
Oaie: pOV�����
1 �ereDY <etldy Ihai I �ave read ��is appliwlion and Slale I�a� ��e above inbrmalion is corr¢ti. 1 apr¢¢ �0 Camply wil� all ciry antl c0unly
ordinances and s�aie laws relaling to �uiWmg consiructan an4liereDy wtMrire representaiive5 o�ro rntu upon 1M aCwe�menlianeA
pmpeny lo� insoectian purD�es. /
Dme' Z��-7�'�� Signawre: ,�J+-+ � ,
Drivei's �icense or Souai Secumy »:
16aLa6 White—BuAOing: Green—CoOe Enlorcemem: Canary—Applicant: Pmk—Revenoe: GOICenroE—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 05119_
PERMI'T NO: E 051193 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N FERMIT TYPz: ELE PURPOSE: OTH
JOB DESCRIPTION : ELECTRICAL METER PERMIT
CLAIM VALUE; CALC—VALUE:
SQ FT:
GROUP OCC: B-2 /
COMMENTS: �
��r+t*�t**+r**x��**�r�r**+�+r**�«+r*+��r+r�*�r�*+�*x�r*�r�+t*�r*�r+r+�x+�*��t�t�r**+r+�*�**�***��*x*�+�***�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BOILDING ---------
FRNT: FT ZN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING RE • PROV; PARCEL: 00000000 2NE: REF NO:
PLANNING iJ 'PES>
>
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D E V E L O P M E N T S.E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY
BUILDING APPROVED HY
APPLICATION ISSUED BY:
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LEGALIZATION:N F E E S U M M A R
BLDG PMT PLUMBING ELECTRZC MECHANIC
PERMIT 1850i
DATE:
DATE:
DATE:
iF if if If iE if iE 1!� i4 iF i(� if �IF iF if iE �1F iF?!� �f iF iE iE iF 1K If iF
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> FERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 18,50 15.00 0.00 33,50 33.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 33.50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
, 33.50
k if k aE k iE iF iF If IE If �(� fF k iE if i� if IF iF iF 1f If M�E iE 1f if i4 iE M if M iF �f k IE i! iF ik iF 1F i(• if �f 1E �f iF iF iF�f if 1E IE iE if i! iE �f 1F iE �E 1F if if af iE+E iE iF 1f 1E Y� iRlt IE 1! k iF
I N D I V I D U A L F E E B R E A H D O W N ,
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50
�� � END OF FEES
�n ��, p �
t �
FEB 2 7 1991 �. ��
CITY OF COSTA MESA
18.50
�
CONSTRUCTION AND PLANNING �'JOL & SPA
APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector
_._.,�
t,. tem0orary Electrical Service or Pole 52. Pool & Equipment Location , �
2. �oil Pipe-Undrgrnd. 53. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgrnd. 54. Forms '
_�4: �Electrical Conduit-Undrgrnd. 55. Electrical Bonding
� 5. Steel Rainforcement 56. Rough Plumbing & Pressure Test:
6. � Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
"7. Footings • 58. Electrical Conduit�Undrgrnd. -
�.8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test
9., Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Strucwral Floor System 61. APPROVAL TO DECK -
11. Propertv Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent•Final
13. fioof D�ains 64. Plumbing System - Final
14. Rough Plumbin9 65. Electrical�Final
15. Rough Electrical�Cqnduit 66. Solar SYstem-Final
16. Rough Electric',Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Ro�gh Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. �Rough Factory Fireplace �. ' � APPROVALS"'���Permit# '
� _ t�.� n.
21.' Ducts, in-Structure , �.. � . 70. Uriderground.Hydro
22. Dutts, Ventitating � ._ � ' 71, Product Piping O'Gas ❑Oil
23. Gas Pipe�Rough & Test � . � �72, Underground Flush- �.
24.�Roof Framing �� � _ =' =73.'Undergrnd.StorayeTank OGas ❑Oil � - •
�. r 'i
25. Roof,Sheathing ' ; ' � ' i �7q,•OverheadHydro- � `
26. T-Bar Cei�ing 4Structuratl & Monocoat • �• 75. Dry Chemical ` = � . �
r
27. Frame and Flashing ', , 1 ; 76. Dry Standpipe , � � � �
i
28. Lathing & Siding � �1 • • � • . � 77.�.� FIXED SYSTEM•FINAL' '�
�29. Insulation � � � ', � ,'"' 78.�FIRE PREV. FINA�L - �� � ; a _
.30. Drywall Nailing . � HEALTH DEPTc REQUIREMENT �
31. Platter Brown Coat' , ,,,, � ���; , 79.�FINAL IN$PECTION-, ; ' ' .
32. Electrical Power Meter-Final �; -.80. .FOOD CERTIFICATE ISSUED
33. Final Electric' . 'Not'es: _ ' " ' . ' ,
�34. •Final HCating & Air.Conditioning , � ' � a ' . - �_ -
:Y.
35.'Final GBs�Pip6-Test' _ ' � 'r� • �' ' L . �
..36.� Hood or CanoPY < � � _ : � � � � � �
37. Final Factory Fireplace • - , ' �` �, , �'r . �: . • • :
�38. Final Plumbing �' -, , �� , � � � �l:.�� = � , , � �
'39. Water Service�Final � ( !' �' • �
i �. . r
,-40. Gas Service�Final . , , '"' _ . � ` �
'41. Solar DOmesticFinal :, •• ' _ `!� �
f.• .� - '
42. Backflow Preventer� � . , y. ' , _
43. Backflow Irrigation• + • • : ' - _
. �
-,44. LandscdPe Irrigation System ; - � . � . � , . -� ,�
:45..Sound A'ttenuation ' � ' � �' - ' ' `�. '
46. Handicap Regulations ' ' � � � � ' " _ . � "
47. FINAL STRUCTURE & BUILDING ' � � - � -
y�,
48. FINAL PLANNING. - � � , � ` �- . .
. 49. Elec[ric Release to Edison ��' ��
50. Gas Release to Southem California Gas Co , �
i �
51. CERTIFICATE OF OCCUPANCY . -
No. Date
G:TY OF�COSTA MESA � � , ,
CONSTRUCTION PERMIT ' �
_„ ,.__ ApPlieant to fill in all spaees except thoie
� . PERMITNO.-' � �T
' - //3��'
heavy Dortler linas an0 sign all aDV�opriate tleclarationz.
!O. ' LOT NO.� , BLD . .
- �.
, PrOIeCtBtldfe55"� � u%" - ^ � -I, 4 TYPEOFCONSTRUCTION_ �NEW ADD ALTERATION
Applicanf'SMailingAddress�; �L7g3�� ���'1G� �- H�l�' ' ❑CONVERSION .�DEMOLISH' DOTHER' � -
� �� ���� DESCRIPTION OF WORK -
Owner's Name . �' D� AnAM S� � 'Phono-p.� . . , � , -
' ,� -. � � 7 „ F'" . .. � � .. . � : I :'. -
ABdf2i5� ��: TVPE OF PERMIT � GRA�ING' ' FOUN�ATION � STRUCTI
Arch/Eng _ L'ICense NO.� � ��� TENANT ❑ ELECTRICAL� ❑ PLUMBING '❑;MECHANICAI
Addless' - ❑ �OTHER - � ' ' �
,� .
Contractoi's NamP J I��{'MbIL L���EGT `.'pho�e Sii.4'GYD6 PROJECT DESCRIPTION' S4: F7. OCCUPANC`
Addresslmailing) -� ��� �G�' � " - � CONSTRVCTIONTVPE � � � VALUATION$_
a � � ZONE GRADINGCV.VDS. ' ACRES.
City LicenseNo. � � �L� � '
LICENSED CONTRACTOR DECLARATION � � Remarks: ' � ' � •
I heraby. atflrm Ihat I am licensetl untler provislons of �Charter 9(commencing ,
with section 7000) of Division 3 ot the Businass antl Profeszion5 Cotle, antl , , � '
my Iicense is in tull force antl efiect. , i , Cy �
LlcenseCl ss �-' D ' � icense o.��Zs�g/ . � � PLUMBING ' '
Date - Signature ' . . ,
WORKE S'�CO�ATION D LARATION ' Baf Sink Show2rs
raby attirm tnat I have a certif cate ot consent to selt-InsurE o'r a certificate. ' Backflow'Preventer ' - Service Sink ' � '
Vorker5' Compensation Insurance, or a certlfletl coDY ihereot (Sectlon
\_ �o, Lab. C.) j ' N7-- � Backflow Irrigation � Sewer Cap '
P ICY No. �,����' ComPanY ��. . . .
� Cartifietl copy Is hereby turnishetl. ' Bathtubs Sewer Connection
\� Car�1j ie-tl 'c_opy� i�I 1g� wlth the city I in9 ISion.
Data� Appncant _ Clarifiers , Solar Collecton �
n EXEMMION FROM l^�ORKERS' C E ATION DECLARATION DiShuYdsher ' SOIa� Pi in
V� (Tnis sectian need not be completetl I the parmlt is for one huntlred (5300) or P 9
less): � . Drinkin Fountains
I certify•that in the performance of the work for�whith this perm�t is issuetl I 9 Sola� Tank
shall not employ any person In any manner so as co become sub7ect to t�e ,
Workers' Compensatlon� Laws of California. FI00� D�ains Swimming Pool w/Spa
� Data Si9nature � � � ,
NOTICE: If,�after making this tleclaration, you 5houltl become subjecbto the Floo� Sinks ' Urinal - -
Workers' Compensatlon provislons,of [he Labor Cotle, you must forthwtth � ,
comply with such provisions.or thi5 permlt shall be tleemetl revoke0.� - GasService Outlets WaterCbset
CONSTRUCTION LENDING AGENCV
I hereby affirm that theie is a construction lentling agency for tM1e pertormance. Intercept0�5 �� ' Water Heater ' •
of the work far whlch this permit is issuetl (Sactlon 3097 Civ. C.)
Lentler's Nameo , ' KitchenSink � WaterService
Lentler'S Aatlress - '
OWNER BUILDER DECLARATION� ' ' LevBtOries � ' '
1 herebv atfirm that I am exemot from tne Contractor•5 License Law for the __
from antl
5 by' an
�..elty ot not
I. as owne
a pe
untlrei
ty or
k, ana
855 dI
an ow
permit Roof DtainS � '
ions ot
i0) of
xempt �
�e<tiOn
a ����� Reinspection Fea �$25
or
' o� tn�ougn nI5 or ne� awn
not intentletl ar offeretl tor
D�etbn, ine ownar wui nave cne ouraen or proving ne/sne aio not owia or im-
�rove tor the purposa o( 5ale). ', � '
LJ I, a5 owner of the Droperty, am excluslvely contractln9 with Iicenzetl con-
tractorstb construct tne project (Sectlon 7044, Buslness anC Professlons Cotle: �
Tha Contractor'S License Law tloes not apply to an owner of property who
bulltls or ImO�oves tneraon, antl wha contracts for such projects with a con-
tractor(5) Ilcenie DurSuan[ to tne Con[racror'S �Icanse taw). .
❑ I am axempt untler Section 8. & P. C. for thls reason
Date Owner
I-heraby-certify that I have r this a Iication�antl-state-ttiat the�abova -
Intormation Is correct. I a9ree�<ompl with all clty_antl pounty ortlinances •,
Signature
Drivers' L
CMF 0865
12/83 wnite
Pink
Boiler • '
Duct - Under Ground
Duct - Structural
Duct � Ventilating �
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU 0100,000
IReinspection Fee �I $25 'I
Goltlenrotl-Assessor � �
Issue Fee
Hood or Typel ❑
Canopy Typell ❑ �
Refrigeration System
❑6100,OOOBTU ❑100,000
System Repair/Alteration
REPAIR
:AL
. f _
A:P. �k
S Main'Build�ng:-
E _ __ .
T F�ont • '
ARear
C Ri9ht
S Left -
Ping. Ref. # ,,
Use of Building:
FEES � �Planning Notes:
.. � t _.. . � _. .
r .r _ �
l� � ��t Automatic Washer
. $ 3
FEES
, � Iwue Fea � $ 3
Cooking Unit � � �
Dishwasher �
Oryers ❑Gas ❑Electric
Fan '
F.A.U.
Fixtures �
Device Boxes
Outlets .
Switches
Garbage Disposal
.fl� 00.5 KW ' 5-�
•4463 E/.17/BA. ;. � � 20.50' 7L'
` • : , ,
� ' . ' � . 4 : �
� ._ ` Zone'. . ' _ .;i +.
Accessory.Building:- _ � Z
� - i. � �_ i .:2, . .. . � �
i . . . i .
� `
Park.Fees $' : „ �
, ELECTRICAL ','
` Transformer ❑ 15-50 KW .
❑ 50l KW
� Meter Dup to 100 amps .
� Meter pover 100.amps �
Sub Panel ' '
" Motors�0.1 HP �t'/:-8 -'
� Ina Solar �9-15 HP 016-15+
'� Microwave
Pole Light
Range
� Standing Sections
5 KW Trash Compactor
I Reinspectian Fee I$y5 � luue Fee
PUBLIC SERVICES REQUIREMENTSi
Zoning APProved BY � . .
Building Approved By
FEES
$ 3
N
I
N
G
R
E
O
U
1
R
E
M
E
� � � SUMMARV OF FEES . '
BUILDING PERMIT .$ SMIP' $ �
� PLANCHECK � ;$ PERMIT
PLUMBING �$ ISSUANCE $ ,
� •PLAN CHECK 25% $ ENERGV P.C. $ '
ELECTRICAL . �$ �CI_,�C1 GRADING $ •
PLANCHECK 50% $ - � MICROFILM $
MECHANICAL $ �TOT/iL FEE $ ��S_�
, PLANCHECK 25%�$ � -� �- ' � �
' � �•CONSTRUCTION"AND'PLANNING � � `• � • P��� � 'OA " - � - ' �� � : � � � �
" � � ' Date � Inspector -' - � � � � � Date' � In's ectoi
�� �APPROVALS �.: Permit# � APPROVALS Pen,.,c# - , _�-P
�" 1. Temporary Electriral Service or�Pole f'' � • 52. Pool & Equipment Location � - � ' ` _ = _ ! .
� 2)(�Soil Pipe-Undrgrnd. ' . �_ � 53. Steel Reinforcement . , /
- 3. Electripl Conduit�Utili'ty-Uridrgmd�'.,: � � • � 54. Forms� - � � -- ��.+'; �
,` 4: EYectrical Conduit-vndfgr,nd�. � - ' 55. Electrical Bonding.. � � - i.
5. Steel�fieinforcement �. � - ' 56. Rough Plumbing & Pressure Test ' :
6. Ele'ctrical UFERGmd.r� , - '� � 57. APPROVALTO-COVER-GUNITE . � ' �; ��
7. Foofings , �� ��'- ' , , � - 58. _Electrical Conduit-Undrgmd.� � . � J
i �
8. FounBation _ I �� �� � ' ,�. � � ~' '- 59. GasPipe,O Undrgrnd.,Test: -� � • .
;. -
9. Wate� Pipe-Undrgrpd. -� - 60. Backwash Lines,.P-Trap, O Undrgmd.�- '` -- ;
10. S4Fuc�ural Floor System ' � . . 61. APPROVAL TO DECK �-� � - -
11. Property Sewer Line & House Coni�ection � 62. Backwash & Receptor-Final � `- � �
. :
12. Sewer�ap � ��� � 63. Heater & Vent-Final - - -
�.� . _ .
73. Roof �rains ; ��' . • �� • 64. Plumbing System - Final � ' - � �
14. RougH'Plumbing � � 65. Electrical-Final � - - . - •
'15: Rou9h Electrical-Conduit " - -� � -� 66. Solar System-Final `-�� "� ' - , � " - '- '- ""�� -'
i �
16.'Rough,Electric Wiriog - , � � 67.. Fenciny &'Access Approval � - _ " �-" "
17,_ Rough Wiring Sign � 68. APPROVED FOR PLASTERING �-
18. �Rough Electrical-T Bar Ceiling� • ' � 69. POOUSPA SYSTEMS FINAL • � ' ��
�..
. 19.:�Rough�Heating &�Air Conditioning i. .- FIRE DEPT. REQUIREMENT � I'
� 20' Rough Factory Fireplace � '' APPROVALS Permit # - �
21. Ducts, in Structure 70. Underground Hydro � ,
c
�21t. Ducts, Ventilating � � 71. Product Piping OGas ❑Oil �
. °�23t�Gas�Pipe-Rough & Test � � • ' , 72. Underground Flush • � , i r J
��24uRoofFraming', . ,, ' . • . 73. Undergrnd.StorageTankOGas��Oil ' � �
� 25. Roof Sheathing � , ' ' _ ' 7q. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical ; ,- i
27. Frame and Flashing - 76. Dry Standpipe '
' 28. Lathing & Siding � . • ' �i 77. FIXED SYSTEM FINAL ' � �
i
�� 29.;Insulation � ' ' i 78. FIRE PREV. FINAL
�
� 30. Drywall Nailing � ' ' � � ' HEALTH DEPT. REQUIREMENT , '
�
'. 31. Plaster Brown Coat ' 79. FINAL INSPECTION �
32. Electrical Power Meter-Final ' (� gt� � 80. FOOD CERTIF;ICATE ISSUED , ,
� 33. �Final Electric � �' - �3 �J. _ Notes: . � � i � '
34. Finaf Heating & Air Conditioning - , � , , . ,
, � . ,
35. Final Gas Pipe-Test � , � � , . . _ . .
�
36. Hood or Canopy , ' � _ � � � � � � . � -
�
37. Final Factory Fireplace . � . � ' � � � . -
� �
38. Final Plumbing � � � ' i . ' • I ;i _ ' , � , �- • � � � �
39. Water Service-Final: � i ' � � ' , . � � � - � �
1
40. Ga4 Service-Final j - � , , . . � � • � ' � �
M � j -
41. SolarpomesticFinel . : � - -. � - ✓ �
1 I 1 � I
42. Backflow•Pre'venter� � � 1 - � � . _ _ � _ , � '. �
43. Backflow Irrigation � , , ' � - � � . .
�. -
44. .Landscape Ir�igation System � � � � • �
45. Sound Aftenuation ,,, , . � � � � , . � • ' -
� -�
46. Handicap�Regulations � � . � ' - . -
i
47. FINALSTRUCTURE&BUILDING , ! ' ��
�
48. Spe�cial Requirements Completed � ' . � � � . � - ' " ' �
49. Electric Release to Edison � � . � ; � ' - i '� � - � ' ��
,
� 50. Gas Release to Southern California GasCo ,. , � _ ' � � ,� � - , �
57. CERTIFICATE OF OCCUPANCY - � - - - - „
No. _ - � � D'ate ' . ' . . . _ . .' .- ' . . . -- - _ . ..
� ADOlicant to fill in all spaces wit�in heavY Dortler Iines antl sign all apvroo��ate Eeelantions.
CIT� OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. ' �BLDG. NO.
C011�STRUtTION PERMIT � - 28 ��
VWn2� vv�1.i.
Address �
Phone
Licenu No.
TVPE OF CONSTRUCTION
BI NEW ❑ ADD ❑ ALTERATION
❑REPAIR ❑CONVERSION ❑DEMOLISH
❑ OTHER
DESCRIPTION OF WORK
Contractor MdRdR �leCLilC Phoneh7�-0/ VpEOFPERMIT '
Address m range, ❑ GRADING ❑ FOUNDATION ❑ STRVCTURAL
LICENSED CONTRACTOR DECLARATION ❑ TENANT�ELECTRICAL QPLVMBING ❑MECHAI
I �eraby aTfirm that I.am IicenSeE untler provislonz ot Cnarter 9(com-
mencing wlth sectlon 7000) o/ . Dlviilon 3 oT the Builneis anE �� OTHER -
Professioni Catl�, '�np my Iicense Is In /ull torce 2�4371 - �
Licen Ci �' �� cen No. PAOJECT DESCRIPTION
Date � � 519natur 5�' �' . �
WORKEHS• COMPENSATION DECIARAT N OCCUPANCV_CONSTRUCTION TYPE
I hereby afiirm that 1 �ave a certlfiwte of consent to self-Insura or a VALVATION ZONE
certlfifzte of Workeri' Compensation Insuranca, or a cerliflatl copY
lhereof (5•,Gtt� �BQO �+obc���7 Firemans Flll'1 GRADING CV. VDS. ACRE$
Policr Ne / 1 W F'�Z P
� xtifieE topy ii �ereby furni5�e4. ' qEMARKS: " '
;rUtieO copy Is flletl wilh the tlty Builtling Divislon. . _
�..EMPTION FROM WORKERS' COMVENSATION DECLARATION -
(53005 or� ess�ee0 no[ Ee completeE I/ t�e permit Is for one huntlretl � , - �
Scert�ty that �n tha per/ormance ot the work tor whith thii permit I5
issuetl, 1 shall no[ emPlay any person in any manner so as to become PLUMBING PLAN CHECK '
subject ta the Workers Companiatlon Lawi of CallTornla.
Date 519�ature BATHTUBS SHOWERS
NOTICE: If afler makinq this tletlaratlon, you ihoultl becoma sub�ecl TOIlETS
to tha Workers' Compensation provisiOns of the LaCor Cotle, you must
forthwith comply with tuch provlsloni or this permit shall be tleemetl LAVATORIES
�evokCtl.
CONSTRUCTION LENDING AGENCV KIT.SINKS
I hereby affirm that there is a conitruction lentling agency for the per- SERVICE SINKS
formance of the work for whith IhiS Oermit is is5uetl (SeCUon 3097
Civ. CJ. - c. , c� � o q � FLOOR SINKS �
LenOer's Wma ` -� -� ` ' '` � � -
�eneer•s Atldress � ! ,'� � � - r` 00.1NKING FOVI
OWNER BVILDER DECLARATION ' INTERCEPTORS
I hereby aHlrm that 1 am Bxempt trom.the Contractor'S Lltense Law for
Ihe following reason (Section ]031.5 Business antl Professions Cotle: SWIMMING POOI
AnY dtY o� <Ounty wh�th rGquir¢s a p¢�mit to ConiVuct, alte�,
uant [O th! p�ovisiOns of Iha Cont�actoYs
�mmencing witn Section 7000) of Divis
olessions Cotle) or that he Is exempt then
le9etl exemption. Any vlolation of Sectl�
'or a permit subjects lhe applicant lo a
an fivC huntlretl tlollars (§500). .
o/ th¢ Oroperty, Or my amplOyees wlth �
[o an
tloes
such
:naea or onereo *or saie. n, nowever, v
altl within'one year oi completlon, the �
proving he tliC nol builtl or improve
I, as owner of the property, am eH
�Of the GASSERVICE
ana Ihe WqTER HEATERS
31.5 by
penalty SEWER CONNECTIONS
as thelr SOLAR TANK
work nimsett or
vements are not
contracting wlth
m ]044, Business
ana vroiMsions coae: i ne connacaors ucansa �aw tloes not apply to
an owner of pro0erty who builtls or improves thereon, antl who con-
lracti from suctl p101ects with a contfactol(s) IlceSnetl Dursuanl f0
the Contractor's License Law). •
❑ I am exempt unaer Sec[ion B. & P. C. (or this
reason
Date - -Owner
I h¢reby certify thal 1 hav! reatl thi5 appliwtlon anU state that the abova
Info�malion is CorrGGt. I ag�ee to comply wlt� all tlty antl county
or0inance5 antl s[ate laws relating to construclion, antl hereby authorize
re0�<Sentatives y? lhi5 Clty [o enter upon l�e abova menNonetl
URINALS
DOUBLE LAVS
DISHWASHERS
SUMPS
GLOOR DRAINS
CLARIFIERS
ALTERATION
OVTLETS �
BTU OUTPUT
COLLECTORS
SOLAR PIPING SVS.
ISSUE FEE
MECHANICAL PLAN CHECK
HEATI NG SVSTEM'. 0-100,000 BTU _
AND DUCTING _ 300,000 + BTU _
REFRIGERATION 0-]00,000 BTU_
SYSTEM 100,000 � BTU �_
BOILERS BTV
SVSTEM REPAIR.ALTERATION
E%HAVSTSVSTEM MVLTIPLE
' Driverz' Li ense or 55 . - ' ISSUE FEE
, CMF 0865-46 White-Builtlin9; Ganary-ApP�iwnl: Pink-Accountin9: Goltlenrotl-Assessor
" '. 2720 3/02/82
ZONE PLNG.REF.$
REAR VARD (TO P/L)
PKG. SPACE RE�. PROVIDED
STREET WIDTH PARK FEE E
ZONING APP0.0VED BY:
SPECIAL CONDITIONS:
�
ELECTRICAL pLAN cHECK
50-FT. GO.FT_ � �
GENERATOR 0-1 KW 1-30 KW �
TRANSFORMER
APPLIHNCE 30-50 KW 50 + KW _
MOTORS 0-1 HP 1-30 HP
(INC.SOLAR) 30-SOHP $O+HP_
FI%TVRES OUTLETS SWITCHES
�GAS TVBE SIGNS
POLE LIGHT$ �
PANELS MAIN � SUB
SERVICE AMP
APPLICATION APPROVED BV � . I
_ SUMMARV OF FEES
BUILDINC�
� . PERMIT E SMIP E
PLAN CHECK E PERMIT
ISSUANCE E
_ �PLVMBING E
GRAOING E
PLAN CHECK E
ELECTRICAL "E� S
PLAN CHECK E M�CROFILM E
MECHANICAL S ' TOTAL FEE E
PLAN CHECK S LE55 AD-
VANCEPC S
23.50 Tt,�
�
FINALFEE E ����0
,
,
CONSTRUCTION AND PLANNING � � POOL & SPA � . � ," '
APPROVALS Permit #�a_ Date Inspector . qppROVALS Permit # � Date Inspec�or
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location ''
�2. Soil ipe-Undrgrn - �- - 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrh ' -- - '- 45�. Forms � ' � �
4. Electrical Conduit-Undrgm - 46. Electrical Bonding �
. tee ein orce - 47. Rough-Plumbin & Pressu�e Test � � �
' 6. "Electrica� UFER Gm - ""' - - �" � ' � 48.' APPROVALTO COVER-GUNITE � '
7. Footings � - --'--" � � ' � "� 4g. EleGtrical Conduit-Undr m ' ' � �
8. �Foundation � � ' - � � ` ,-.-r - - - - ' -50. �Gas-Pipe, � Undr m, Test � � "
9. Water Pipe-Undrgm 51�. �� Backwash Lines P-Tra 0 ndr rn
10. SfructuralFloorSystem - """ - -'"" -52.'APPROVALTODECK
� 11. Property Sewei Line & House Connection•�.�� � � � � � 53. �Bsckwash & Rece tor-Final � ' ' ' " ` ' � ' �
!-'"12. StreefSewerConnection-�-- i;,.-�� - . ;.,� ,.. 54. Heater&�Vent-Final � � ' � '
-13. Rough Plumbing. ' . ."__ _ . - --- - ' . .... _ . ' . „"i�s•; .v 1'1,. 1.
''14: �-Rough ElectricConduif -- ` - ' `� '- - - _ �56.. Electrical-Final ,' ' ' � � -" '
' @5. Rough�Electric-Wiring- -- �- , ---- - -- 57. So.larSystem-Final �� ' . �> � . � � �� � ��� � � �
1�6. Rough Heating & Air. Conditioning._ _ _ � _. � encing & Access Approval �' � ' - - ' - . "
17: DuctS in Structure � � �?-•• � ' ' • APPROVED�FOR PLASTERING . ' � �� - �
18. Ducts, Ventilating � - - ' � � � � - . � " - , �
' 19. Gas Pipe-Fough &Test � ' � 460. POOL/SPA SYSTEMS�FINAL - �-. � ., � � . .�
20. Roof�F.raming � ' � � . � � ' • � •� � ' ' . ' "• "
I 21: - Roof She�athin - ti � � � � � � � . � . , . , ,
22. Frame and Flashin -- NOTES: � . � � . . �
23. Insulation ' � - � L � - , -
24: Lathing &$iding � C.0 � 5 o Qti �LE C- C- ,3 -
�'
' 25. Drywall Nailing � ' �� � �'- ' �
. 26. Plaster Brown Coat � , � � � ' ' � '
27. Electrical Power MeterFinal � � � � � � ' � � ' '
� 28. Final,Electric �� ' � � ' ' � - ' " - ��
29. Final-Heating & Air Conditioning � � - '
30. Final Gas Pipe-Test � - ' � - '
31�. Final Plumbing � i � ' • �
. , 32. Water Service-Final . � � � - ^ � � ' � � � �
33. -•GasService-Final ` � � � '
34. � Solar pomesticFinal -. � - � � � r � �
35. Landsca e S rinklin S stem " � �' � � � � � � �
� 36. Sound Attenuation ' ' ` '
37. Handicap Fegulations � - - - -- ' � '
38. FINALSTRUCTURE&BUILDING � � � -
39. Special Requirements Cornpleted ' � , � � � � � � ' -
, 40. Electric Release to Edison � � - � ' � - -
41. Gas Release to Southern California Gas Co. �- ' " - ' " -'-'
42. CERTIFICATE OF OCCUPANCY � � �
' . � No _ Date ' ' - � - - - ,. . .
. _ . � �' � �'i �� : ). . �
_ " ' ' ' ' _. ' . . . . . , � \ _
,
� ADo���ant to /ill in all spaces within heavy bortler lines ana siqn all aoDropriate eecHrations. "
t
61TY,OF-COSTA MESA P MIT NO. - TRACT NO. LOT NO.. BLDG. NO. - � -- - - -
CON$TRUC`TION PERMIT ' 2430 2/23/82 �`� ' 4.00 7L
.
Project Address % ' �f , � TVPE OF GONSTRUCTION � � � _ _ � - , � � �
' Owner (�J ; p � Phone (� . 'O New f� �.DD ❑ ALTEHATION � � ' ' '- - ' '�
Address- Q« 'ffq . ❑ REPAIR ❑ CONVERSION ❑DEMOLISH . _._ , _' �
; Arch/Eng. - � -� License No. - . ❑ o7HEa ' ZONING REGULATIONS- '
7 ' ' A.P: $ ' "" .
� � Addr¢xt � . DESCRIPTION OF WORK ' ' - . . . ._" _ . , •_ .
' ZONE ?LNG. REF. �'
� � Convecmr - (, C � Phone� - .S TVPE OF PERMIT - �� �l�I�firvG
SET ACK O Y LINE�
� ' Addrezs � ^� � � ❑ GRADING ❑ FOUNDATION- ❑ STRUCTURAL � � I VARD - -
V` I�hereby aDf'CrONT_RAC�mOR Osetl untl¢r provizlons of Cnarler 9(com- ❑ TENANT �ELECTRICAL qPLUMBING- OMECHANICA 5Ip HTA
i manGing-�wit� SBCtion. 7000) ot DIV15ion 3.oL tha .BUSiness antl _� OTHER W A G _
Profeszions Cotle, anC my Ilcense Is In full forte anG etfe t REAR VARD (TO P/l)
PROJECT DESCRIPTION
LJtense Clasi � j.� tens No.' Q / � PKG. SAACE REQ. 'PpOVIDEO -
Dale ��^1�/- �.- <��atvw � iu�i'��_ SQ.FT. ' . .' _' .. _ . _. '
WORKERS'COMVENSATIONDECLARATION 'OCCUPANCV_CONSTRVCTIONTYPE - STREET.WIDTH - ,-PARKFEES
9 bereby affirm tbat 1 have a tertiticd[a ot tonsent to selLinsurc or a VALUATION 20NE � ZONING APPROVED BV " DATE - -
tertlfl�vte of-Workers' ComDensxtlon Insurante, or a certl(led'copy . _ . _ _
thereof (SecHon 3800, Lab �j�Q GRAOING CU. VDS. ` ACRES 15PECIAL CONDITIONS: " . -
PoIICY NoeY�C6mP�ny �AG1&�MA/�SF�.O ' _ - " __' _ ' . ' '
'erti(letl coOY �5 hereby fur,nishetl._ . _ _ qEMqRKS . + _ ,
ertifietl copy is filee wi[h [�e city Builtlin9 Division. . � ,
i
c..EMPTION'FROM•WORKERS' COMPENSATION�DECLARATION • - - ' � ' - --
(Tnis section neetl not be completetl if the permit is for one huntlretl ' " '' " �
(5100) or�lessl' ' - ' _ . . ' ' _ - " . '_ _ ' ' ' _ ' " _ ' "_ ""� _ ' " ' " " '�
1 C¢rtlfy that in [he pe�fo�mante Ot the work for whith [his pe�mit Is
IStu¢tl,' I shall nOt emplOy dny p¢r50n in any manner So d5 to b¢COmG' -. PWMBING ' -" .�PCAN'CNECK " -' 'ELECTRiCAL -' ' PL'AN'CHECK- "
5ub�ect to the Workers _Compensatlon l_y�y5 of Californla. ' ' .
Date � Signature � BATHTUBS' " ' S1-10WER5 ' - ' ' ' ' - ' -' ' '
NOTICE: If aftar making this Geclaratlon, you shoultl become subject TOILETS. � � ��,URINAlS -� -.GENERATOR �•-0-1 KW_id0'KW '
to ihe Workers' Compensation provi510ns oi the Labor Cotle,-you muit � TRANSFORMER �-
� /orthwith comD�Y w��h tuch provisiong or [his permit shall be tleemetl �VATORIES' DOUBLE LAVS - - AVGLIANCE 10-50 KW=50 + KW � --
revoketl. _ --_ _ . . - KIT.SINKS '-" "DISIiWA5HER5'• -- -- MOTORS - - �-
CONSTRVCTION LENDING AGENCV ' O-1 MP�1-30 HP- �
I hereby atflrm ihat ther¢ I5 a constru��lon lentling agenry Por the per SERVICE SINKS . SVMPS �-•' � - - �UNQ SOLAR�_ .. �P50-HP�_ 50 + HP - �
�ormance oi tba work tor whicb this pe�Mt is Issuetl (Section 3D97 '�' � � i
Civ: C:�... - • - -- • -- " ' FLOOR SINKS "FLOOR DRAINS- � FI%TURES "OUTL•ETS � SVJITCHES - -- -
'Lender's Name � �
�Lentl¢r'SAEUress � ' - ORINKING'FOUNTAINS''"" ' -' . - �GASTUBESIGNS - - -- - �-- - - �
OWNERBVILDERDECLARATION��.. - �� � -'�� "�-�� "INTERCEPTORS � ��-"CLARIFIERS ' � - ' POLEIIGHTS - - - -^-- -�-- - -
I hareby atfirm tnat 1 am exempt M1om tho ConVacior's License Law ior
t�e followin9�reason•�Secllon ]037.5 Butinoss-antl Prolei5ions Coan: -SWtMMING POOL - �PTRAP •. • - :- y-' � '.ppLES � �METEREO � SCIB - -- - "'
Any tltY or county which requires a permit to <onstruct, aller,
improve, tlemolish or repair any structure, prior to i[s Issuan<e, also re- yyATER SERV ICE" - '-ALTERHTION �� - � PANELS-- ' -MAIN -� �- SUB - � -
qWreS Ih¢ ap:licant 1ot Such parmlt tp {��e a signetl Stdtemtnt Iha[ he - -
Is Iitensetl pursuant to lhe�provizions of t�e Contra<tor's License l.aw GAS SERV ICE --OUTLETS' - �, SERVICE - --�^ -� AMP�--- - - '
1Chapter 9(tommencin9 with SectiOn 7000) ot Divislon 3 ot Ihe -
9usines5 antl Adessions Cotla) or that-he�is uxempt tneretrom antl tho yyqTER HEATERS' BTU OUTPUT � • - �
basiz for the alloged exemption. Any �Iolation of Settion ]031.5 by � �
am+. appliwnt-lor a permit subjects the-applicant [o-a civil panalty SEWER CONNECTIONS � - i� -' - - - - - --� - - -- - - - - -- - -- � -
q„'�m�¢�`-� more than five huntlretl tlollars (E500). -
�+"-?is owner of'tne'propert or'm em lo ees with wa es as tbeir -SOLAR TANK ' COLLECTORS --� - -- - - - �- --- -
�L;.�. � Y. Y" P Y 9 ' ' _ ' ' ' ' ' . " _' " '
�J�. '
so�c�.ompensation, will tlo lhe work, 8ntl thC sVucture i5 not in[entletl
or oHer¢tl tBr"sale.�(Section 7044, Bu;iness antl"Profe55ions CoOe: The -SOLAR PIPING SVS. - - -' " - � "" -' " ' ISSUE FEE --- • • - � � - -
Contractor•s Llcense Law tloes not appry to an owner of a property � ,. . .__ ' -qppLICATION AVPROVED-BV- - �-- - DATE- �
who builtls or Improves thereon, antl who tloes such work himselt or - lSSUE FEE" -' � i � - �
throu9h his own GmO�oyee5, provitletl tM1al Such irOp�ovem¢nts are no[
intentletl or of(eredtor za1e. I�, howeveq the-builtling or improvement ryjECHANICAL ��� PLAN CHECK � �� � � SUMMARV OF FEES
IS Soltl wi[hin ona yea� 01 completlon, the owncr will have Ih¢ burtlon �
ot�proving'he tlitl no['builtl or improve br tne'purpose ol sale).- HEATINGSVSTEM 0-100,0008TU - ,BUILDWG. --•- - . .' . -
.
❑ I,.as .owner ol the property, aM_extlu5ively conlractinB H'��h AND DUCTINQ . PERMIT S _ _ � SMIP •_ 5. , _ �
IlCensetl contrdttOrs to construct tbe pro�etl (Section ]044, BusinGii 100,000 + BTU PLAN CHECK S PEI7MIT: �
5ntl Crofessionz Cotle: Tne Contractorts License law.tloes not appty to - ..� ISSUANCE S� "
an owner ol property wM10 builtls or improves thoroon, antl who com REFRIGERATION 0-300,000 BTU • PWMBING E . �; �
�rdtls t�om-suCh.prOfeclS.wl�h a coq(rattor(5) Ilcasnetl.0ursuant..to. SVSTEM- -- { - � � - � .- _ ��'GRADING�7E"" "F
ihe ConVactor's License Law�. 100,000 + BTU PLAN CHECK �f ._ � .� -�
❑'I am exempt under Section --- B. 6 P. C: for t�is BOILERS BTV � �� ELECTRICAL� -S ��� � s
reaSOn� .. . � MICROFILM S
Dale Owner SVSTEMREPAIR,ALTERATION PLANCHECK E � --
�iMECHANICAI E TOTAL FEE y
I hereby certiy Ihat I have reatl this appp�y�lon antl slate that the abova E%HAUST SVSTEM MUI.TIPLE ' ' � � LE55 AD- .' '
inlormation' is'correct: I agree'lo camply'wltn all tlty antl county ��P�AN CHECK� �E � VANCE PC"S _� ^
ortlinances anG sta laws relatin9 to conztruction, anC nereby aut�orize � , .. ,_ ��
representatives o tnis clt - to ter on -the aCove mentionetl - - � � '
property for i pecllon u • '� �p
Signature Da[e��� , _ _ ._ ' FINAL FEE S�
Orivers' License or 55 � � - �SSUE FEE - -, - - . _ . _ . _ ._ .- _ _. _ . _ .
CMF 0865�46 White-Builtling; Unary-ApP�icanh Pink-Accoun[ing; Goltlenrotl-Assessor '
CONSTRUCTION AND PLANN�IN--�G ,,.,^.�� POOL & SPA ;• ��
APPROVALS Permit # 1�L_L� Date Inspector � qppROVALS . �� Permit # � Date ` Inspector
1. Temporary Electrical Service or Pole ' 43. Pool & Equipment Location - �
Soil ipe-Un rgrn 44., Steel Reinforcement �"- �
i
Electrical Conduit Utility-Undrgrn 45. Forms - � �
4. Electrical Conduit-Undrgrn 46. Electrical Bondin _ � -' - -
. tee ein orce ' 47. Rough Plumbin & Pressuie�Test -
6. Electrical UFER Grn 48. APP,ROVALTO COVER-GUNITE �- • -- - � - � • - --
. 7. ootings � � 49. Electrical Conduit-Undr rn �� - �
8. Foundation. - 50. Gas Pipe ❑�Undr m, Test � '
_9. Water Pipe-Undrgrn - 51. Backwash Lines P-Tra � 0 ncTr m` ' " '-
. 10. Structural Floor System 52. APPROVAL TO DECK � � � '
� .1L __P.roperty Sewer Line.& House_.Connection ' 53..._Backwash & Rece tor-Final , ' - �
. 12. Street Sewer Connection ' " - - 54. � Heater & VenbFinal � • �- •
73. . Rough Plumbing � ' - " �- " - ' ' ' "'
14. Rough ElectricConduit ' ` � � �56: Electrical-Final- - � � �
15. Rough Electric-Wiring ' �� � 57. Solar System-Final �
' 16. Rough Heating &-Air Conditioning - - � • encing & Access Approval . �
17. Ducts in Structure - ' APPROVED FOR PLASTERING � �'
16. Ducts, Ventilating -- ' � . . � ,.
79. Gas Pipe-Rough & Test - � - � 60. POOUSPA SYSTEMS FINAL '. �• .
20. Roof Framing �- � � � - - - �
21. Roof Sheathin � - - - - � �
22.� Frame and Flashin - - �- - � NOTES: � , . " ' � �
23. - Insulation - - - - , ' ' � � �
c ¢ c ; ,e�
24: Lathing & Siding - � - -- � � - - L► r � - - -
25. Drywall Nailing� � � � - �
� 26. Plaster Brown Coat ' � - - � � �
27. Electrical Power MeterFinal - � - � - ' ' �
28. Final Electric - - � - - �
29. �Final Heating & Air Conditioning � ' � �
30. Final Gas Pipe-Test - � �
37. Final Plumbing -
- 32. Water Service-Final � � - ' •
n
33. Gas Service-Final • � � '
34. Solar pomestic-Final • �
35. Landsca e S rinklin S stem � ' -
' 36. Sound Attenuation � �
� 37. Handicap Regulations ' ' ' � �
38. FINALSTRUCTURE&BUILDING ' � • - �
� 39. Special Requirements Completed -
' 40. Electric�Release to Edison -
41 . Gas Release to Southem Califomia Gas Co. � � �
42. CERTIFICATE OF OCCUPANCY �
i. ._
No Date � , . . . . , i
. -- � �
ADP�icant to flll in all soaces wlthln neavY bortler lines antl sign all apv�opriata tleeiarations.
CITY�F COSTA MESA P MIT NO. �"" TRACT NO. ' LOT NO. BLDG. NO.
�' GONS�RUCTION PERMIT � ;�1�'�]
f �.
rro�ect ntltlress ��d �y . iW S/ ��- . TVPE OF C�O/NSTRUCTION
Owner ��j � ' - PhOnB�./ ❑ NEW �p ADD ❑ ALTERATION �
Addrea' �3�j u�j /%�-5i; - : _ - �REPAIR ❑CONVERSION ❑DEMOLISH
ARh/Eng. - - - � - � " licCnse No: ❑ OTHER
DESCRIPTION�i WORK EL%rG/C�
Address" _ - " _' " _ . , '_ ' ' _ "' ' _ dE.�C�/GE
• Contracmr �- E C� - Phont�f' ]Q TV,PEOF,PERMIT . .. - . . ... ..
�-AddfeSs - � � E�j1q -" �� ❑ GRA�ING. ❑ FOUNDATION ' 0 STRVGTURAL
LICENSED CONTRACTOR� DECLARATION ❑ TENANT � ELECTRICAL-OPCWMBING ❑MECHANICP
{I h¢reby affl�m fhut 1 am IlcenseC unCer p�ovi51on5 of Charte� 9(COm- ��' � ' , , �
'mancing wkh��section 7000)� oi' Division 3 of -tha Business antl ❑ OTHER-
Professions Cotle, antl my Iitense is In twl force antl e(t cL � pROJECT DESCRIPTION
,License Class ' � d� LicenSe N . 37�� � � , �
Date � I �-B Z " 519natur � �' SQ. F_T. ' � "- " . " "'� _ .
WORKERS'COMPENSATION�OECLARA ION- _ ' OCCUPANCV=CONSTRUCTIONTVPE� �
1 h¢r¢by atfirT that 1 have a certiticate of consent to self-InSura Or a VALUATION � � ZONE
certiTiwte of Workers' Compehsatian-Insuranta, ar a certl(ietl coDY � � - �
thereof ( ction 3800, b. C.). ' i GRADING CU.-VOS. ACRES
roiicv rv�e�/T�v'pvJ7o40�lFoany �/QF_�lA.�'S /YiA»� -- --- -
� Certltietl copyls�hereEy furniShetl. . . _- _ . , . REMARKSi� l�_ �' . _ . . _ ._
Certitietl copy Is�filetl witM1 th¢ city Builtlin9 DlviSiOn. . . �
EXEMPTION FROM WORKERS�COMPENSATION DECCARATION - ' - -""
'(This.SCGtiOn neCtl �not b¢ cOrOp�et2tl if, the p¢�mlt, IS.Po� one.huntlr¢tl -
(E300) or Iess). � . . '.'- . , _ ' " - . _ _ .
.I tertity that In.the performance ot.the work for_whlch tnis permit is
isiuetl, I snall nol employ any person in any manner so as to become � PLUMBING'.• � -' -.PLAN CHECK' ��
'subject to the Workers: Compensation Laws of �alifornia.`- ,_. - ' ' _ _ _ ' _ _ ,
IDate Sl9nature � B/�THTUBS SHOWERS� ' '
INOTIC£: It atter making [his tlitlaration, you shoultl become',suEjeti . TOICETS •, �� �.� ��WRINALS ' '- ' -
-.to the Workers' Compen5ation p�ovisions Of the Labor Cotla;you must _
for[hwlth COTpty wi[h suGh pro��5ion5 or thi5 permit shall be tl¢¢m¢tl LAVATORIE$ DOVBLE"LAV$ "
�revaketl. _ � ' ' - ' . _ . _ ' ' ' ' _
�CONSTRUCTION LENDING AGENCV � KIT.SINKS � -- � "' DISHWASHERS ' " � ' '
'I hereby aftirm ihat ther¢ is a construc[ion lentling agency tor the per SERVICE SINKS � SUMPS'- �''- " �'-
�,formance of tne work for whic� thls permit is issuetl (Section 3097
Civ. C.). '� -- - - '^---- -"— ""-' �"' -' ' FLOOR SINKS �� � FCOOR DR7iIN5 � �� � `
FLentler'S Name
�LentlerY AtltlresS � DRINKING FOUNTAINS � �-� ' --- '
OWNER'BUILDER DECLARAT�ON- -- - '�-- ' '-' � INTERCEPTORS CLARIFIERS� �
1 h<reby affirm that I am ezempt from Ih¢ Conlracto�'S License Law for
�� [he ap'�IiWn[ tor zuch permrt to
�.nsetl' pursuant to the•provisions'a
�ter 9 (commencing with Sectlo
ess antl' Profeszions Cotle) Or thaF
tor tbe allegetl exemptlon.. Any
ipplicant tor�a�De�mit-sublects't
t mOre than /ive huntlretl dollars
as own¢r of lhe piOpe�ty, o� my
ompensation, will tlo ttte Work,.a
'ered for ul¢. (Sectlon �OA4. Busi
actorf5 Lice�Se Ldw tlo¢5 Pot.ap
ouiltls or improves thereon, antl
9h his own,em0�oyees,.pro`/�tletl �
rtnm one year or compreu�n, �
nq M1e tlitl not builtl pr impr
ownerv oL [he proper)Y.. �am
¢' Conf rdCtor'S �License � Law
000) ot Oivision 3. of lhe
s exempt l�er<irOmantl Ihe
ition of Section 7031.5 by
applicant t0 a �Clvil �pGndlty
00).
ployees with wages as thei�
he SVuctur¢ is nOt in[entletl
: antl- Professions Cotle: The
to an ownet of a p�ope�ty
tloGs such work himself or
sucn improv_ements are not
he bulltling b� Improvement
owner will have th¢ burtlCn
for the pu�pose of sale).
intl R'otMsions-Cotle: The Contlactor's-LI<¢nse Ldw�tloesnotapply to�
an owner of property who builGz or improves thereon, antl who con-
tra<ts-irom�sucn pro)ects-with a-contractor(s) lic¢snetl pursuanGto
the Coniraclor's License Law�.
0'1"am'exempt under"Settion " -- ' " 8. 6"P. C. for this
rea5on - - ' - ' - - - - -
Date. Owner
'�I hereby tertify thal 1 nave reatl In�s applica[ion antl 5[ate lhat tne above
infarination is mrrect. 1"agiee to comply with all city and cou�ty
ortlinances antl stat laws relatinq to cOnstruction, anE heteby auth0/iie
�represen[atives o his- City'to eoter upon lhe -abov¢' mentiOn¢tl
property for ' pectio urpo •
Signature Dat��� �Z
SWIMMING POOC `P'TRAP' ' ' ' - _' ' -
WATER SERVICE � ALTERATION ;, i
GASSERVICE � ��OUTLETS � - -��-
WATER-HEATERS ' - BTU OUTPVT � -�' '-
SEWER'CONNECTIONS ' � -' ' '-' '- � -
SOLARTANK " - " -COLL'ECTOR$ ' � -
SOIARPIPING�SVS-' '•." -� '- '- "-
ISSUEFEE - ' ,�`� ��-�� - "- '
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-]00,000 BTU
AND DUCTING - 100,000 � BTU
REFRIGERATION 0-300,000 BTU
SVSTEM - � 100,000+8TU
BOILERS BTU�
SVSTEM REPAIR,ALTERATION �
EXHAVSTSVSTEM MULTIPLE �
Driveri' License or 55 �k - %� � � ��-� � �SSUE FEE - - - - � -
CMF 0865-36 White-Building; Canary-Applicanl: Pink-Accounting; GOltlenro0-Azzessor
` °� • .2431• 2/231.82 ` ��..
ZONING REGULATIONS
A.P.9f f' . . ..
ZONE . PLNG. REF.. � . .
VARD (TO P/Ll ..
8.00 TL�
�
PKG.SPACERE�. PROVIDED
STREET WIDTH � GARK FEE 5 i-
ZONING APPROV ED BY - ' OATE - -
SPECIALCONDITIONS: � ,�_ ,.� , - .
_ — - - :i � ,-.�— -
� �. - .t.. , �.
ELECTRICA'C � - - " PLaN CHECK '
5(1FT_ ' "" " _ . '_ _.
GENERATOR ' 0-1 KW_�1-30 KW �
TRANSFORMER . ��• � �7'�
APPUANCE ' 10-50 KW -_50'+ KW' ' � '- '� —
MOTORS . 0-1 HP-_1=10 HP^ � '
INC. SOLAR � '
( )'--30-50'HP-y50+HP - - - —
'FIXTURES � 'OVTLETS ' SWITCHES - " " " �
GAS TUBE'SIGNS " "-- -'—""' ' "� - - --
(
POLE'L'IGHTS----'- -� '"---" '" " -"' -'
� .' .
POLES METEREO SUB
PANEL$ —"MAIN- � � SUB �, i C� i
'SERVIC O�/ /T •' '�'(�AMP"�'_;..'
' " ` _._" _ " �. ' �.` . "_ _�"_ '
_ _ ' _ ._ . _ . i
_. ..' ' . '� ' _'"'
ISSUE FEE '--' -"— ' "'� - "'" " -'
'APPCICATIOMAPPROVEDBV - - ' --DATE---�{
� SUMMARY OF� FEES .. ,. . � - -' '- � 1
� �BVILDING"'" ". . � _. . . '"' " ' _
�PERMIT § _"" _-.- .SMIP,�."_'_S .'
� VLAN CHECK $ PERMIT• ' �' �
� ., �
- " ' -""' """ "' _ �ISSUANCE f�- � "----
�PLUMBING b i.. .: . _ !
PLAN CNECK '§ � -' -GRADING' b' �
�y.i �- . �' , ^ i
_ oo- �- � S '.
�ELEGTRICAL 5��._.." " ' �t' 1
'�PLAN CHECK"E' "- - -'� MICROFlLM E' "
"" ' � �TOTAL FEE b ���
-MECHANICAL E "
•:PLANCMECK E "-� � 'LESS�AD- ' � - t
--VANCEpC' E_ �
� . •, � _ , . � �.
' � ' ^ O��
x
. , FINAL FEE $ Lf
CONSTRUCTION AND PLANNING POOL & SPA �� _ !� - �
APPROVALS Permit #�..Z� Date Inspector qppROVALS Permit #-' - � Date _ Inspector '
1. Temporary Electrical Service or Pole 43. Pool &' Equipment Location�• - - - ' - -
Soil ipe-Undrgrn � • 44. Steel Reinforcement -- � � - � � • -
3. Electrical Conduit Utility-Undrgm � - �� - - - � 45. , Forms - - � � � �-
4. Electrical Conduit-Undrgm_ .46. Electrical Bonding � - - - �-• - - - � - - � �-
tee ein orce -- 47. Rough Plumbin & ressure Test ' �`� � -�
6. Electrical UFER Grn ' - ' - 48. APpROVALTO COVER-GUNITE - - ' - � - -
7. Footings � 49. Electrical Conduit-Undr rn
._8.__ Foundation ' �� 50.., GasPi e„ � Undr rn, Test � '
� 9._ Water Pipe=Undrgm __ ' 51. Backwash Lines P-Tra ❑� �ndr ��n� � - �-
70. Structural Floor System. 52. APPROVAL TO DECK " "" '' "
.11. Property Sewer Line & House Connection ° 53. Backwash & Rece tor-Final • • '
. 12. _Street Sewer Connection ' � � � 54. Heater & Vent-Final '
13. Rough Plumbing - � ' ' � - � � ' � � -` �
14. Rough ElectricConduit '�--�----- - - � �56. -Electrical-Final - � � • � , �
. 15. �RoughEleciric-Wiiing " � "- - - -- -57: � SolarSYstem-Final ' ' ' _ �
' 16. Rough Heating�& Air Conditioning - - - - - � � encing & Access Approval '
-17: Ducts, in Structure... . ' " ' ' ' APPROVED FOR PLASTERING '
18. Ducts, Ventilating .�� � ' . . . .. _. � _ __
19. Gas Pipe-Rough & Test - • ' ' ' � ' 60. POOL/SPA SYSTEMS FINAL - • - �
20. -.Roof�Framing ' � ' ' ' - ' � ' � ' � '
21. Roof�Sheathin ` . � � - ' '� �' � - "'
NOTES: • � , .: • , . ' '
' 22._ Frame and Flashin .. " , ' �
23. Insulation � �- � - ' ' ' ' �
24. Lathin & Siding ' - - - - � - � - � -
25. DrywallNailing � ' ' ' � ' � ' ��
' 26. Plaster Brown Coat � �
27'. Electrical Power Meter-Final"-' � � � � '
28. Rnal Electric - � � � � �' � '
- 29. -Final Heating & Air Conditioning - - � � �-
30. Final Gas Pipe-Test ` � � - � � ,
, .31.- - Final Plumbing � � �
� � 32. -Water Service-FinaP - � � � " � � � � �
33. Gas Service-Final _ � � � � ' `
34. Solar pomestio-Final � � ' • - �� - '
35. Landsca e S rinklin S stem. � � � ' � � �
� 36. Sound Attenuation -
37. Handicap,Regulations ' � � ' '
38. FINALSTRUCTURE&,BUILDING ` -
. 39. Special Requirements Compleied` ' ' " -
40. Electric Release to Edison ' � -/-d' ' - � -
41. Gas Release to�Southern California Gas Co. •
' 42. , CERTIFICATE OF OCCUPANCY � ,
]
No�. - Date - - - _ --
FS
W
W
a
Q
�
y
.1"
F
o�s��o
COSTA MESA BUILDING-SAFETY DEPARTMENT
P_O. 90X 1200 COSTA MESA. CALIFORNlA 92626
7714 '10/26/78 5.50 TL+
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only qECE� V ATE RECEIVED o r issu '
BVILDING r ' ^ �� ��"
/>4DRES5 w a
' + - � PERMIT NO.
OWNER "G I NL� A.P.NO. �I � O' O�
BUILDING f '/1 I
P.DDRESS ADDRESS 3Q W� {� �
TEL. TRACT LOT BLOCK
CITV �� NO.
WNSTRUCTION A P
L&NDER
BpANCH
OWNER
AbDflE55 VALUE r �'
AqCHITECT TEL. S $ ��O
Op ENG�NEER
FIRE
�+bDRESS ZONE TV E GROUP
�� APPROVED
CONTFACTOR BV DATE
�+bDRE55 Z 20 NO.OF USE OF NEW
TELr p�.qN$ BUILDING
CITV N0�1 �
S7ATE - % 1 C CITV �'AR SAPPROVED VARDSAPPROVED
LIC. NO. / S^ �O J LIC. NO. MAI BUILDING ACCESSORV BUILDING
SIZE NO.OF B�DGS. IFAOM C/ STREET)
aF LOT NOW ON lOT RONT FT. FT.
U$E OF
E?(ISTING BLDG. I T FT.
Separate permits are required (or L SIDE FT. FT.
electric, plumbing and heating work.
REAF FT. FT.
U5E OF BUIIDING AND WORK TO BE PERFORMED DISTANCE BEf. BEf. MAIN &
MAIN BLOGS. CCESS, BLDCS.
���_ VAR.� TE
C.V.P. q� OVED
APPROVED
I hereby acknowledBe Met I have reatl ihia application and state
thet t�e above Information is rorrect and aBree to comply wlth ,
el� lews regulatinp builtlinp connrucNon, enC I shall not employ
a�y person in vlolntion of Me workman's eompensetion laws ot
the State of California.
I hareb certif �hat I am SQ. FT.
y y proparly Iicenud aa a conttactar untlar
tha Smta of Callfornia B�sineu entl Profanions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOH i
Chapier 9, and that such I(censez are in full forco and etfecL or I THE PURPO6E OF ESTABLISHING A PERMfT FEE ONLY:
em exempt from the Orovislons of tha State oi Calitornia Busineas VAIUATION pERMIT FEE S D�
a�tl Professiona C Dlvlsion/y. Cheptor ;
B �A � //�'__� $ � PLAN CHECK E
51 �nt�re of �i '�� i
P9rmlttea _� �1 � � TAX S � O
i
Autho/izetlApant T07ALPAIO E �
AOPlicant to illl in a11 sDaces ezee0< <hose within neavy Gortler Ilnes ana sign all appro0��ate aeclarations.
CITY-OF COSTA MESA . � PEf�v11T NQ. _ _ TRACT NO. LOT NO. i BLD . .
; CONSTFPUCT.IQN PERMIT
I P ' AAr1 'l'� G� �
Applicant's Mailing Addreu SZ��- �-/ NGC�G.J Gy/I
/r
Owner'sName CA�LG � /�%OeG.�'c�C- Phone
Address � 2. t7o / C%FUQASGo Co%o�✓/t Gt�/�i/9�
Arch/Eng. License No.
Address
Convactor's Nam �AG� �� � ��=�'�� Phone ��` � Z7� �
Addresslmailing) SZ5�2 LlnJGOL� G.�P��.2.ij
City,LicPnse No. ' �
LICENSED CONTRACTOR DECLARATION '
I hereby affirm that I am IicenseC untler provislons of�Charter.9 (commencing ,
with section 7000) of Division 3 of the Business antl Professions Cotle, antl
my license:is In full to�ntl,eitect. . •
License Class '�� � � � License y���u �
Date�'�Z—B3 Siqnature' G � ' '
WORKERS' COMPENSATION DECLA'RATION � � � �
' hereby aftirm that I have a certi(icate of consent to self-insuie or a certificate
f Workers' Compensafion-Insurance, or a certifietl copy�theGreof (Sectlon-
J800, Lab. CG.� 3�s� 3�� � STA"TC /'"�'� �
Pollcy Ntl7� Company
�Certitietl copy I5 hereby tumishetl.
Cert}JIeG c�op� fl�letl with tha�city Builtlin ivis' n. '•
Date �� Applicant a—�
EXEMPTION FROM WORKERS'�COMPENSATION-DECIARATION '
(Thissection neetl not be compleletl it the permit is tor one huntlretl (8100) or
less).
I ce�tity that In th¢ pe�(o�mance of th¢ work to� which this pe�mit i5 is5uetl I
shall not employ any person in dny manner so,a5 to become subject to t�e
Workers' Compensation Laws o( Calitornia.. � � � �
Date • Signature �
NOTICE: It; after makin9 this tleclaration, you shoultl become subject to ihe
Warkers' Compensation provisions of the Labor' Cotle, you must forihwith
comply witti suth ,-provisions or .tnis permit 5hali be tleemetl reyoketl. �
CONSTRUCTION IENDING AGENCV "` � �
I hereby afiirm Ihat tnere IS i Conitructlon lentlin9 agency tor t�e pertormdnGe
ot tne .work tor whicn�h� perm' is, IssueA- (SecHon 309� Civ. .C:)
Lentler'z Name _ _ -
Lentler's Atltlress _
OWNER BVILDER DECLARATION ' - '
t hereby affirm that I am exempt irom the Gontiactor's License L.aw tor the �
�..un..,�nn .wacm �cncHnn �0315 Rusiness antl Professional Cotle: Anv Gtv o�
TYPE OF CONSTRUCTION �
❑ CONVERSION ❑ DI
' DESCRIPTIONiOF WORK
TYFE OF PERMIT LJ GRnDING
❑ TENANT ❑ ELECTRICAL
❑ �OTHER
GROJECT DESCRIPTION Sp.FT.—
ADD U ALTERATION DSI REPAIR
fHER
— /% NU - U iC/(.�
7FOUNDATION STRUCTURAL
PLUMBING ❑ MECHANICAL -
CONSTRUCTION TVPE - - ' VALUATION $
ZONE GRADINGCU.VDS. AC
Remarks:
%;`�•reirom anG the basis for the allegetl exemption. Any violatlon'ot Section
`"31.5 by any applicant for a permit subjects the appliwnt-to a civil
�'$nalty of,not more than five huntlrea tlollars ($500).
'� 1, as owner of the property or my employees with wages as their sole
compensation, will tlo [he work, antl the structure is not intentletl or offeretl -
for sale (Section 7044, Business antl. Professional Cotle: The Contractor's
License Law tloes not ap01y to an'owner of a property who builtls or improves
thereon, antl who.tloes such work.himself/herself or through his or her own '
employees, provitled that such Improvements are not intentletl or ofteretl �or
sale. If, however, the builtlin9 or improvement is soltl within one year of cOm-
pletion, Ih¢ Owner will.have the burtlen oi proving he/she Gitl nOt builtl or,im-
�rove TortM1e purpose of sale�. '
I, as owner ot the property, am exclusively contracting with licensetl <on-
� traCfors to con5truct the prOj¢ct (SectlOn 7044, Busine55 and Protessians Cotle: �
The-Contractor'z License .l.aw doe5 not appty to an owner oi property who :
buiitls or improves thereon, antl who contracts for such projects with a con- '
tractor(5) license pursuant to'the Contractor'S License Law). �
❑'.I'am exempt under Sectlon B. & P. C. for this reason
Oate . Ownen � � � �
1 hereby certity [hat I have reatl tnis application antl stzte that the above
informacion is'correct.'I-agree [o comply'witn all city antl,county-ortlinances' '
antl state laws relatin9lto builtling con5truction, antl hereby autnoriie reore-
sentatives oP this� tlty, to'enter upon e above-mentionetl .property for
inspection pur eypj 5. �-� ' � L
!/y..�{a�_ D t / �Z"+��
Sink
Backflow Irrigation �
Bathtubs -
Clarifiers
Dishwasher ' • � �
Drinking Fountains
Floor Drains . •
Floor Sinks �
Gas Service Outlets'
a
Roof Drains
Reinspection�Fee
Service Sink '
Sewer Cap
Sewer Connection
Solar Collectors �
Solar Piping � �
Solar Tank
Swimming Pool w�
Urinal
. Water Closet � .
Water Heater
- Wate� Serdice .
. �
$25 . � Iwue Fee.,
Boiler �
Duct-UnderGround ' � i
Duct-Structural � �
Duct-Ventilating � �' ��
Exhaust System ❑ Multiple ��
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0�100,000 BTU � 100,000 BTi
Signature ,
Drivers',License or 55 � � �� �,�� � Reinip0ction Fee
�
CMF 0865-46 rev. 7/83 White - Builtling; Canary
Pink - Actounting; Goltlenrotl - A55eszor
Hood or' Typel ❑
Canopy Typell ❑
❑0-100,OOOBTU ❑100,OOOBT
System Repair/Alteration ' � �
��
Issue Fee
FEES
a
I ' $ 3
�
$ 3
A.P. #
S Main Bui
E
T Front ,
B Rear
A
C Right
K Left
5
Ping. Ref. #
Planning Notes:
Auromatic Washer
Cooking Unit � .
�IShNYdifl2f
Dryers ❑Gas� DE6
Fan
F.A.U.
Fixtures
Device Boxes
OUtlets
Switches �
Garbage Disposal
Generator �65 KW
2one, f --
Accessory Building:
Park.Fees $
1
ELECTRICAL
' Transformer ❑ 15-50.KN
0 50.+KW
•Meter ❑upta100amps
� Meter ❑over 100 ampi �
Sub Panel
Motors O61 HP O 1%- 8
Inc.Solar �9-15 HP 016-15+
' Microwave �
� Pole Light '
Range
� � Standing Sections
5-15 KW Trash Compactor
� Reinspection Fee . � $
PUBLIC SERVICES REQUIREMENTS:
Zoning Approved By '
Appliwtion Approved By �
Aoolication Issued Bv
BUILDING PERMIT
PLAN CHECK ,
PLUMBING
PLAN CHECK �
ELECTRICAL
PLAN CHECK
MECHANICAL
PLAN CHECK '
Issue Fee
SUMMARY OF F
g �-3fl•Oo
fl
$
$
$
$
$
$
2
O
N
1
N
G
R
E
sanir $ O. S6
PERMIT .
ISSUANCE $ �
ENERGV;P.C., $
GRADING $
MICROfILM $ � 7
TOTAL FEE ; $ /JO ; ^�
CONSTRUCTION ANDPLANNING ' ' , ?OOl ,PA - ..
APPROVALS Permit #� � g � Date ' Inspector� - 'APPROVALS Permit # � Date - Inspector .
1. Temporary Electrical Service or Pole t� .. - � 52. Pool & Equipment Location �
' � 2. Soil Pipe-Undrgrnd. - , .. • ' � • _ 53. Steel Reinforcement �
� - •
.�'. Electrical�Conduit Utility-Undrgrnd. � � � 54..F.orms � ' � .
�
,4. Electrical Conduit-Undrgrnd. • �� � 55.�-Electrical.Bonding � . � •
� 5. Steel Reinforcement •' . . . 56. RougFi Plumbing & Pressure Te;t .
6. Electrical�UFERGrnd. � , 57.:APPROVALTOCOVER-GUNITE . - '
7. Footings'� . � _ 58. Electrical ConduibUndrgrnd. ' � - •
8. Foundation �' � ,� ' 59:'Gas Pipe, � Undrgrnd., Test � ,
9., Water Pipe-Undrgrnd:, � � . 60. Backwash Lines, P-Trap, O Undrgrnd: , r,
10. Structural Floor System , ' � � 67. APPROVAL TO DECK � • � '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ,
12. Sewer Cap ' � , ' � 63. Heater &�Vent-Final . , . .
13. Roof Drains � - - 64. Plumbing System - Final _ .
74. Rough Plumbing . 65. Electrical-Final
15. Rough Electrical=Conduit • . 66. Solar System-Final - .
� 16. �Rough Electric Wiring - - � - 67�. Fencing & Access Approval . �
17. Rough Wiring Sign . � � 68. APPROVED'FOR PLASTERING �
.�1$. Rough Electrical-T Bar Ceiling � � , 69. POOUSPA SYSTEMS FINAL � �
�19. Rough Heating &�Air Conditioning , FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts-, in Structure �� , 70. Underground Hydro � ' • -
t
22. Ducts, Ventilating ,' �. ' � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test ' 72. Underground Flush � .
24. Roof�Framing '' , 73. Undergrnd.Storege Tank O Gas ❑ Oil �
25. Roof Sheathing :� -�, 74. Overhead Hydro , -
26. T-Bar Ceiling (Structural�� & Monocoat 75. Dry Chemical
27. Frame and� Flashing ' ' � 76. Dry Standpipe �
28. Lathing & Siding � , � , '' 77. FIXED SYSTEM FINAL �
29. Insulatiori '� '� � , 78. FIRE PREV. FINAL
- 30. Drywall Nailing � ' . � HEALTH DEPT. REQUIREMENT
31 � Plaster Brown Coat � 79. FINAL INSPECTION ,� � . �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
33. Final Electric � Notes: ' .
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test .- � � � , .
36. Hood or Canopy ' ' , � ' �
37. Final Factory Fireplace � " � - ' "
38. Final Plumbing ' ,
39. Water Service-Final �
40. Gas Service-Final ' �, � � , � �
41. Solar pomestio-Final • ' _ ' _ �
42. �Backflow Preventer ' � �
43. ,Backflow Irrigation � � � . ' . �'j < ' ,
44. ,Landscape Irrigati'on System , � , . ' �
45. Sound Attenuation � , � � "
46. Handicap Regulations ' , � � � . �� �
47. F.INAL STRUCTURE & BUILDING g�9 3 B
48. Special Requirements Completed � � � � � ' � � � � .
49. Electric Release to Edison i � . ' ; - - - � � • � •:,,� ; t ' . ,
50. Gas Release to'Southem Califomia Gas Co � � i ' �; ' . v� �
51. CERTIFICATE OF OCCUPANCY: , . , ,. . _ '".;� � �:'
NO. Date � , ' •
�
�
\
1
�,
AVPlicanl to /ill in all spaces exeept thase wlthin �eavy Eortler Iines antl 519� all aOCroprlala tleclarations.
CfTYOF �OSTA MESA - '
CONSTRUCTION PERMIT
Project Address � �� W � �
Applicant's Mailing Addrea SZ$�z L/.JCO�- <-1 C'7/� �
Owner i Name rR �C� N O t�GK C�t-ahone
Addreu 7�O� c/%c� %sA:s�-o ��,�„�,r oK- inR�-
Arch/Eng.. � Licente No.
Address
Contracror's Nam= P����' �^'�EST ohone �� �27 �
Addresslmeiling) ����2 L����^� �'"t�
Ciiy LicenSe No.
LICENSED CONTRACTOR DECLANA710N
1 hereby atflrm that t am licensetl untlar provislons of-Charter 9(commencing
with sectlon 7000) of Division 3 of the Businett anG Profes5ion5 COGe, antl
my license is in full forca anG eftect. Z�//u�
LJcense Class � L�icens�e%� �o.� ��
Date �'�Z'�� SI9naWre ��/-�T-�-�^�
'�ORKERS'COMPENSATION DECIARATION�
nereby affirm that I have a certiticate o( �onsent to self-insure or a certifiwte
o( Wo�ke�5' COmpensation Insu�ance, b� d ce�tifletl copY �hereof ($ectlon '
3800, L2b. �L ' /{{(f S�%�i� Fc/N�
Policy No. � �3 ��� •- c...npany
Certifietl copy is hereby turnis�etl. n
Cerl ietl copY � ilee with the city Bui�In�iWsi7�. �///.- �
Date ��/i�� APPIiCant � i!��D�-�i'�
EXEMPTION FROM�WORKE0.5' COMPENSATION•DECLARATION
(This sectlon neetl not be completetl it the permit Is (or one huntlretl (5100) or
less).
I certlfy tbat in the performance of tha wiork for whlch thii permR is issuetl 1
shall nol employ any person in any manner so as to Eecome subjett to t�e
Workers' Compensatlon Laws of Califorhla. '
Data Si9nature
NOTICE: I(,'aftlr making thi5 tl¢clatatlOn, you ShOUItl beComO Sub�ect to tne '
"Workers' ComOensaUon D�a��sions of tha Labor Cotle, you must forthwlth
I�omply wlth such Orovisions or l�is permit ihall Ca deemetl revoked.
CONSTRVCTION LENDING AGENCY -
I nereby a/firm that there is a constructiq� Ientlin9 agencY !or tha performance
of Ihe work lor whith tbii,��mil is IuueU (SacHon 3097 Civ. C.)
.i I�ntler's Namn ��'�'�
I„enaar•s Aaaress
OWNERBUILDER DECLARATION -
1 horaby af/lrm that 1 am exempt Irom tho Conlrattor'S Licenze Law for tha
following reason (Sectian 7031.5 Bu5in0s5 antl Profeislonal Cotle: Any city or
county which req Wres a permit to conitrutl, alter, improve, Eemolish or repair
,_.. .�...�.��... ...�....., u� i.���,...e ,i<.........i.....ne �....n.,... r... ���.n ..e....0
,are/rom ana tne ba515 f0� Ne allegeG exOmpUon. Any vlolaLOn'ot Sacuon
/031.5 by any appli<ant for a petm❑ sub7ects tho appllcant to a civil
�enalty of nol moro t�an five huntlretl tlollars (5500).
I; as owner o/ tne property or my omployeos with waqei as thelr sole
componlation will tlo lhe wo�k, dntl the st�uctu�e IS not Int0n0etl o� offeretl
/or salo (Sac�lan 7044, Business antl Pro/euionai Cotlo: The Contractor'S
License Liw tloos not aDV�Y �o an owner p( a pwperty who bul�As o� Impmve5
thoreOn, dntl w�o tloes such wOrk �ImSel(/her5elf or thrOugh his or her own
Bmploy0e3, pfovitl8tl tllal Suth ImprovB�nOnts are nOt Intentletl Or offete0 /Of
sa18. If, hOwevBr, the bUiltling or ITp/oyement IS SOItl within On0 Yea� of com-
D�otlon, the ownar wlll bave t�e burtlen pf proving �e/S�e tlltl not bu(Itl or im-
�rove fot tbe purpose ot ule�.
I, as owner of the properry, am exclusivaly contrac8ng with Iicensetl con-
Ifdttols t0 constfuct lhe ploj¢Ct ($ectlo� 7044, BUSInG55 dntl R'01eS51oni Cotle:
Tho ConVactor's Llcease Law doas not apply to an owner of properry who
builtls Or Impfovei theleon, anC wllo contfacl5 10r SUCh OrOjlcts witn a con-
Vac[or(s) Iicense pursuant to,the Contra�por's License Law).
❑ I am anempt untler Sectlan B. d P. C�ar thii reason
Date Owner
I hereby Certify [hat I �ave reatl thi5 application antl Stdta tnat the aDOve
Intormatlon Is correct. I agree to compiy with all city antl countY ortlinance5
antl'state laws relatln9 to builtling conbtruction, antl hereby authoriza repre-
sentatives of. t�is dty to enter upoq t��mentlonatl ProPerty tor
Inspectlan pur s. � � Z�B�
SignaNre Date
Drivers' License or 55 �
- a'lo7D
TVPE OF CONSTRUCTION LI NEW LI ADD L1 ALTERATION f�l REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK A��'�� � m GE
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ �OTHER
PROJECTDESCRIPTION Sq.F'r. �zb� OCCUP Cv
,CONSTRVCTIONTYPE VALUATION ����
� ZONE GRADING CV. VDS. ACRES
Remarkt:
' /�-eiGOa ���
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers �
Dishwasher '
Drinking Fountains
Floor Drains '
Floor Sinks
Gas Ser'vice Outlets
Interceptor5,
Kitchen Sink �
Lavatories
P-Trap
Roof Drains� -
Reinspectian Fee $y5'
Duct- Under Ground
Duct - Slructurel
Duct - Ventilating
Exheust System ❑ Multiple ❑
Firepl/Fect.8lt. ICBO #
Heating System & Ducting
❑0.100,000 BTU 0100,000 BT
Reinspection Fee
'CMF 0865-46 rev. 7/83 ' White - Buittling: Canary - APP1lcant: Pink - Accounting; Goltlenrotl -
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Soler Piping
Solar Tank '
Swimming Pool w/Spa
Urinal
Water Ciout
Water Heater
Water Service
laue Fee
1ANICAL
Hood or Typei ❑
Canopy Typell ❑ �
Refrigeration System
❑0.100,000 BTU ❑100,000 BTU
System Repair/Alteration
laue Fee �
G'
a
A.P. 5W
S Main Build
E
T Front
B Rear
A
C Right "
K Left
S'
P�ng. Ref. #
Use of Building:
Planning Notes:
Automatic Washer
Cooking Unit
Dishwasher �
Dryers �Gas ❑EL
Fan
F.A,U. .
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW �5-15
n
Zone
sory Bui
Park.Fees $
ELECTRICAL
Transformer ❑ 15-50.KW
❑ 50+KW
Meter Clup to 100 amps
Meter �over100amp{
Sub Panel •
MOtors 047 HP �7'rS - 6
Inc.Solar Q9-15 HP �16-15+
Microwave
Pole Light
Range
Standing Sections
Trash Compactor
S 3
Reinspection Fee $25 laue Fee
FEES
PUBLIC SERVICES RE�UIREMENTS:
Zoning Approved By
Appliwtion Approvec Ry
53
BUILDING PERMIT
PLAN CHECK
PLUMBING
P�AN CHECK
ELECTRICAL
PLAN CHECK '
MECHANICAL
PLAN CHECK �
2
O
N
I
N
G
R
� E
O
U
I
F
' E
N
E
• N
. T
$ 3
SUMMARV OF FEES
$ IS•OO SMIP $ O.S�
$ PERMIT
$ ISSUANCE � $ �
$ ENERGV P.C. $
$ . GRADING $
$ MICROFILM $
$ ' TOTAL FEE $ � • SO
' CONSTRUCTION AND PLA N NG _� PO� , SPA �
� /� Date �Ins ector �
�� APPROVALS Permit # �`�' b P APPROVALS Permit # Date Inspector
. i. Temporary Electrical $ervice or Pole • 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. • 54. Forms �
� 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding _
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
. 6. Electrical UFER Grnd. " � 57. APPROVAL TO COVER�GUNITE
7. Footings ` 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � � 60. 8ackwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � ' � - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
.76. Rough Electric Wiring 67. Fencing & Access Approval
7.7. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electriral-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
`20. Rough Factory Fireplace APPROVALS Permit #
21: Duc[s, in Structure 70. Underground Hydro .
22. Ducts�, Ventilating , 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing , � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation �, 78. FIRE PREV. FINAL
' 30. Drywall Nailing �� , . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' Notes:
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test
36. Hood or Canopy � �
37. Final Factory Fireplace � �
38. Final Plumbing' , ' - � '
39. Wate� Service-Final � � .
40. Gas Service-Final � "
41. Solar pomestic-Final � ,
42. BackflowPreventer �' �'
43. Backflow Irrigation " ' ; �
44. ,Landscape Irrigation System " �
45. Sound Attenuation
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING � �
48. Special Requirements Completed
49. Electric Release to Edison . � ' !
50. Gas Release to Southern California Gas Co � ' �. � � '�
51. CERTIFICATE OF OCCUPANCY . _ � ��� ''
No. Date , • _
cr�--- � , •
Counfy `af'-O�ange
'.Building Departmen4 '
Room 322
CourF House Anne:
Santa Ana, California
Phone: KI 2-6211
1. OWNER'S
APPLiCATION FOR
PERMIT
MAILING ADDRESS ?�� S C� a�
SG��Seroee or P. O. Boz No.i
NAME
(ArcLiuce or Q(neer)
ADDR�SS
CITY�
State Lic.
2. JOB LOCA
Phone
��
a
t
PfiRMIT NO.t� � � �
.
19—
PHONE: �a v Ga i I I��
IV� CITY �� ✓O YL U VC � l l G Y'
NAME ��/�+^
( naacwr or euJd.r)
ADDRESS _
CITY.
State Lic.
(Hwae No.) (N�ma of S�reet) (Tovn or $rhool Diurict)
�.,� �,_T�� � � vc.�
3. LEGAL DESCRIPTION: Lo Z qBlock Tract �ie6e r SO
4. Meets and Bounds Descziption — Use Reverse Side of This Form. 00 � �✓ ^��y� �
5. CORNER LOT () INTERIOR LOT � THROUGH LOT () SLOPE OF LOT
THIS AFPLICATION CANNOT BE PROCESSED UNLESS LEGAL DESCRIPTION
IS ACCURATE AND COMPLETE.
6. PROPOSED WORK: New Building (� New Structurc () Addicion () Repaic ()
Alrerations ( ) Move ( ) Demolish ( ) Conversion ( )
7. -PROPOSED
S�
8. SIZE OF BUILDING �`1 x Z � AREA 2Ff� SIZE OF LOT AREA Z Rc rc-1.
9. CEILING HEIGHT� TOTAL BUILDING HEIGHT R� `I NO. OF STORIES �
I0. NO. LTVING UNITS — SIZE OF SMALLEST BEDROOM SiZE OF KITCHEN '-
11. EXTERIOR WALL CONSTRUCTrI�Q N: Brick O Coneretc Tile O Monolithic Concrete O
� e'/G.1 Wood Frame ( ) Steel Frame ( % Concrete Frame ( %
12. WALL COVERING: Wood O( ) Metal O Stucro O
t3. FRONT YARD SETBACK FROM CENTERLINE OF STREET
5e �p /0 6.,...
14. DISTANCE TO PROPERTl' LINE: Side Yard_ I Rear Yard _
t5. SHOW ON PLOT PLAN EXISTING BUILDINGS NOW ON LOT, STATE USE OF EACH.
16. DISTANCE I[�1 FF&T FR017 PROPOSED BUILDING TO NEAREST EXISTING BLDG.�-
17. VALUATION OF PROPOSED WORK: Including All Labor, Plumbing, Electrical Wiring, Heating, Fia Sprink-
lcrs, Painting, Sewage Disposal � %.-r��
18. I HER$BY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION
IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCT70N WORK WILL CONFORM
TO ALL LAWS OF THE�COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE
THER$TO.
Plan Fi1ed.
i BY �� � ✓, ` /� AWho�izM A6eM
Da[e ��. � '� ' �
FOR DEPARTMENTAL USE ONLY
' C�M i S
19. GROUp �i TYpE � nISTRICT MAP NO.
PERMIT FEE $ �� d RECEIPT NO. _� PAID TO � DATE 7 ia .�.�r„ /
CHECKI[VG FEE ,$ RECEIPT NO � j�� `'
�. nxMtmr–ri-M� .
PERMIT GRANTED J U I 1 4 L95(1 19—,
PLAN$ CHECKED BY
APPRqVED BY:
HEALTH DEPT
STAT� FIRE MARSHAL
STAT$ DIV. OF HOUSING—
OM—IS-�9 � �
6 0 0 �"
�e��
INSP�CTOR
T
� +
<<• ; �
Q
�
COUNTY OF ORANGE
� BUILDING DEPT.
636 No. Broadway
Santa Ana, CaGfomia
Phone: KI 26211
Application for Building Permit
AND FOR A
Certificate of Use and Occupancy
Permic No..,r,`'.�'...,�p.,.��
Date ........................J..- --��'''---�/...---'•
OIVNER'S NAME..�.l...�lCs/F.�..�.r.. �_L�Q .r.-Z.�:�./... v�HL KC!�...--f!(l.C:.•.. PHONE :............._- -----------�--
. /' � �/�
MAILING ADDRESS- ...��LcS ---�- �G..f..?,�..T.........�.� .Y../.� .......................... CI'CY..LG..��'iys7...4'�L_('/'C�� .
Name .._!_`�./�'..N...!4..�..��_._..--- ���.�.-�ti..'� ............. Name .....l�./1l�_......-S�.�T �.'."-�� �..�.-�...------........
(Arthitat oM1&wgiwaor� � LCon[rzc[or)
/�I/.f' � .v s ....-- -,a,c_ �io_, /�/ G..g ^a s r_ �.c vg.-�---
Addre=_s --- - -- - ... .7' ...�.... Address ......... . ..._�...........-- ---- ---------------
- --�- - -� - ,� ,
c:� Ce�.�..n ��. _�_"./.f.�:�'--_...-- c;� C�,�n,✓�...,..�F..c�_._/%9�---------
Y� ........-- � ............ ............ . ------�--- � Y ----....... ---- �
State � �/' State ? / ' ��
Lic No ........ .......................... Phonc%./.:�iC�'.t...����C(....... Lic. No...�!..��..F�1�.....�..L Phone./7Cd�:--_�.��'..��
PROPOSED USE
JOB LOCATION....---..�,a3G_.....(�(�:......�. . . � . . . � ..�CEE7�..��........L O S T.4..,_ ��ESr�i .:..............
....._........
- ........... ....."---
� (House No.) � (Name of Strect (Town or Sthool District),/� ��j
LEGAL DGSCRIPTION: Lo�✓L{,l.... .��. ����5....Le7��R�.Block ....-- ....................._.................... Tract.../.Y..�r_Gu.O�.P>_�"/�Sfj
(Mctes and Bounds Description—Use rEverse eide o( (arm) "' �
CORI`'ER LOT ( ) INTERIOR LOT ( x) THROUGH LOT ( ) SLOPE OF LOT ( )
. ,. . �� Py
p p T'
S1ZE OF BLDG,«�"�..�I:.�.�:.'O..AREA:....�1�..�...........SIZE OF LOT:..�...�C!��,�..AREA:.---...--------__---...........
G. HEIGHT OF BLDG.:....... ��/._/ ....................CEILING HEIGHT:..... ��.../...�._��....NO. OF STORIES..........._�.._...........
7. NO. FAMILIES.......----_�--_---........Size of Smallest Eedroom:--------_---------------------_....--- Size of Kitchen..._........-. -__..___-
S. [XTERIOR WALL CONSTRUGTION:.S�.r?NC... ����`!�..INTERIOR WALL COVERING ............................................
(Framc, Stucto, Etc.) (PlastervDrywall, Etc)
9. SETBACKS: Front Yazd From Center Linc of Svect--_.-------� �. a... /... ._ �_v _5 .......................---.--------------......--------•-..----'
rr i � /
Nearesc Side Yard.__... ��1.-...__...Rear Yard_._... ��._....._..Distance in Feet Between Bldgs. on Same Lot.._...___��._....__._..._..___.
I0. A COMPLETE PLOT PLAN IS R[QUIRED, SHOWING ALL STRUCTURES AND USL OF EACH.
/ �� u y� n
1 I. For (a) Footing: Width----.....�[o ........... .............Depth in Ground_..-.-�.�.-._--........Width of Wall--.--.--.[�...--------'--_--
Accessory
Hldgs. and _.____.____.Spacing ............... "CC Material of Floor...._..__.�?..._. .. ___.
5imilar �b) Size of Srods---------------- ....-.------. w/C.G� f
5tructures: r
(c) Size of Floor
iYK�7
(d) Size of Rafcers:.-- �--.��..�....-------Spacing....------' � ------.......-........"CC
12. VALUATION OF P�OPOSED WORK: Includina all labor, plumbing, electrical wiring, hcating, fire sprinklers, painting and
5ewage disposal 5....��Q_�[>.L?..t.- ...............
13. T HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CQNFORM TO ALL LAWS OF
7'HE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
�./ , / $igned:
Plans Filcd :..............4.�1....��..._�.......----�---.........-----"By:
FEES:
Bldg. Pcrmit
Plan Check
Total • •
Reccipc No.
Paid ro •
DATE......_�Ii._ .�.."..:...__.
9M-2.01�^\ �
, � �
FOR DEPARTMENTAL USE ONLY
GROUP.....-.y. .�.��.���...j� .................
TYPE....-----fc+y.� . . ................
DIST. G.� /.1/
MAP ......... . . ... �� �..............
SHEET NO. � .................
�
�'� �� .., �.� �
L:f�
APPLICATION...��...�.�/./� �I-IEALTH ............................
ZONING......._...._-..--v FIRE
PLANS AND Y MARSHAL.__...._ .............._
SPEC'S.- ---.....-----............ STATE_ . ..... ...... . . ........
CO�RR���L OF TF�EI��EER
COU[CTY OF ORANGE
� BUILDING DEPT.
r
' 636 No. Bcoadway
Santa Ana� California
Phon¢: KI 2-6211
, � °� �%��� Y `.
Perm� ..__�_].-_��---'--�7``�L�
Application for Building Permit •
AND FOR A
Certificate of Use and Occupancy
Dace----'-'------'-' — �"-� --�_-'_� /--'-"'--"---'
OWNER'S NAME.----�/?�TC.H..�«�._._/�L2_G,�",i'.._L._.!�//Q=�Y�.'�----.-�'�/.�---- PHONE:.---------------------------
l � / �}/�
/ Of.�?„S-T--------�L_V._�•.- -------------�- CITY.__�"�'G�{,?----d_dt----- -`�l
MAILING ADDRESS__ ��_..r-----_�- - -- - - t - - ' < --'C'(.
Name_!.\:___CN/9��'"'_"__�.E.%.Ge�.'_""_"""'___' IVame.""""""Y-� /y�/ 2""_._�C..�____L�4�.Q_�__�.�.._'____'
.i � -- -- --
(Archirec� or�£ngk�eC:.�„re � " -... (Contraccor)
Address -��-¢•�'�---�'`-2dT...._�.L.��?..�------------- Address.----...��./.f Coq-S--�-'----�'�'��-Q-'---
- ---------- -
Cit �- O..�o=y'-�--- -�E.l�-----�:Lf1L�-----------
y__ - ------� -
$tate L
Lia No. -------""- "-"----- --,---' Phonc _._!p�t.R?te.__Z�.P.
PROPOSED USE:
2. JOB LOCATION..
3.
4.
5.
6.
/7�
C(c �.r�Q.^i,�i..----��.�...--/-.:f.�i��.--------
y"_'....'--- - -
$[ate /
Lic. IVo..,�,�4.�Q.------ -----. Phone - .9R�31J-`�-`''-�f�
3� O o .�
(House No.) (Name of S[reet) (Town or School Distri<t) �,I '
w�y z �`' /pw �4'T /%?s
LEGAL DESCRIPTION: Lot.------------ � �--Q-�----------.Block --------------- --- --_._-Tract � ---�- ----- -------Y-
(Mcres and Bounds Descripoion—Use reseree side of form) ��Ok s- p� ��
CORNER LOT ( ) INTERIOR LOT (� THROUGH LOT ( ) SLOPE OF LOT ( )
, / , r, �
SIZE OF BLDG.�.�--�- �b.--- AREA:----Z'Z-� a------ ---.SIZE OF LOT:- - - ----------- -- AREA: ----- -- --- ------- --
� " ' -r-
HEIGHT OF BLDG.:.______�3.-'_�.___.._.__.CEILI[VG HEIGHT:._..ID_______-._.....-.-NO. OF STORIES.______�__..._.._
7. NO. FAMILIES ._--_-----__�� _----._..Size of Smallest Bedroom: -_--=-- '-----_.---_-. Size of Kitchen : ....................._-_.-------.
8. EXTERTOR WALL CONSTRUCTION:L_Si7SQl.�!¢'x_..._._.__.INTERIOR WALL COVERING __._../.'/R1'OtY_�.7/
(Frame, Stucco, Etc.) (Plasaer-Drywall, Etc.)
9. SETBACKS: Front Yard from Centcr Li�e of Strect.-------_--/00--,------ fPeG.(d.S---_-----__--------------_-----'---'-----_..-- _---__-' ---
/
Nearest Side Yard____________________._.Rtar Yard.__.___.._......._..__.Distance in Feet Between Bldgs. on Same Lot __.. SQ..__�C v_'�.
lG. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AIVD USE OF EACH.
11. For
Accessory
Bldgs. and
Similar
$tructures:
12.
r �/
(a) Footing: Width �� ___.. Dcpth in Ground....��.,__._ _ Width o£ Wa��
..........._'__'__.__"'.._. ........_. .._..._.._ "'.....'_"
(b) Size of Smds:.'__----_-----_'---_"---.Spacing__-'--_'---'--'-_-""-"--'- CC Material of Floor._-..S...a��!%F..'�
(c) Size'o£ Floor Joists:
(d) Size of Rafters:'-'-----_-'--__-__-_-'-._-'---
.��
"CC
VALUATION OF PROPOSE�tluding all- _-'.�elcctrical wiring, l�au+�8� f+ee-yPrn*kkre, -��^t-
i � r�----- ------5?._.O_._� %------- f-' ' � �
I HER�BY CERTIF� THAT TO THE BEST OF MY KNOWLEDGE ALVD BELIEF THE I[VFORMATIO[V IN
THIS APPLICATION IS GaRRECT AND Ti-IAT THE COtVSTRUCTION WORK WILL CONFORM TO ALi.
LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Plans Filed:.-------_--_"-'�-_ _�-- _��
'_'_'-'--'-'-' -'--'-'-
FEES:
Bldg. Pennit
Plan Chcck
To[al - -
Receipc No. -
Paid to -
llatc ...-- --'---
FOR.DEPARTME[VTAL USE ONLY
D�J'--- GROUP--- l----�-------� --
C4�fJ•? _ TYP6.._._�.�._.._-----------------
�QQ___ DIST.
MAP.------ ----�-�-----��/-----
71/ % i SHEET NO..__�......_.__..
CH�CKING BY
APPLICATION.�'.._._t�HEALTH ______________.____..___.
FIRE
ZONING._._.-----------�--- MARSHAL--------------------
PLANS AND
SPEC'5.---•------------------- STATE.....------------------....._
CORRECTIONS ENGINEER
VERIFIED .--------------.... CAL..---------- --------�---- -----
PERMI VVIiVL� iiV�P_CTOii
.
.
DATE.------/�`---��V---�-/---------�---- . EPUTY
9m-).90
N
^h
V
- Costa, Mesa Buililing Dep`aro..._..�R � ' APPLICATION �OR PERMIT :
^ ' . 111 EAST 20th STREET ��2 �___B U I_L D,�,N G_�_
' '� COSTA MESA, CALIFORNIA ,-' -
FOR OFFICE USE O�v_ ; �, �
FOR APPLICANT TO FILL IN t �-
Reeeipt No. Permit No.
s�;,a;� /� ��� ` � 1 `- , gG Z � '!
Addrcss CJ!`�0 lrl. l�'�'� �1T ' � J 1 I
L'OSt& M85&� California Reeeived by� Date ec'd. Date Imued !
� � :i �—��`—S� �I
Nearest � '
CrossSt �uPC��o4 a� Building � �
_ _ _ . Address : .
Mail
Addi
nrohitect or
Engineer ��•
Address —
�treo�ar � J.� �cl�6C
AdQ�ess Y T4 �ltiW.e?a ,D2.
Legal Lot i// �.p��
Deacription I No. �� �--I 8%ck—
(Attaeh Metes and Bounds)��y � ,
_. _ . . b i i .. � _ / � No.
Center
New
amiaing �
Size �fC/.<
terior ZVall�
•ering ,,,S�U�
se of NeW
Cross St.
No. --
!3' j Rear
Side
ns �
Root
Tract
� ¢
bYesa, California �
i
�
_ _ _ '_ __ ' _' . ., O
o.ot 9•,'.�Dd A
ooms � �
o� ----- -�-- �- �----'� "--�- - Z
!A h t.:� . S'�7 ^i ..:..i�a� r'
�
Buildin -� Foundation Loc:
9 /p�a�'� !TC/.ti>�!"S � Forms,Materi
Under-Pinnin�
Frame: Fire Sto
� Bracing, Bolts
Lath.lnt.
I hr.reby acknowledge that I have read this Application
and state thet the above is rnrrect and agree to comply Lath. Ext.
with all City Ordinances and State laws regula[ing
building 4onstr tion. plaster, Int.
Signatureof � J^L/A��„�/
Permittee Y�.Iw,.<..n C. Y//f/� L�4e
IlWtldn / Pel'mlt FeG $ �_O o
% �� �rj � Plan Check S • J
/� C%� �� Total U",� D
Fee S �
„ rzoa r.. �M 1't-63
APPROVA�I,S• � j�f,,N
loy. � (NG � %�}_ o I �ate
� _ . .. i ..._,. � ...1... . . (.. . L�L] ' '� •.• .. 'J .�._....._. .. . ..�. ...(��
_ � . . � , . � )� .A � �V �J��.I��ui�i:. ��i%i.. i. . �
_
AI�-.-.G':I. 'J 'o_i.- .. L"J
_" � I..._"__' _ _' _'__— _ _ .
/
✓
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i 6 J
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a
, - - - -- � .
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,• - . .
- - - - - . . ;�
, ,, , - - -• -
I� � , . ' - -- - -- -- �
I ; '
Street
' � PLOT PLAN
, Show Iocation and distanees trom
property line and between buildinga
� • - '�- " _ - �r.....
� .. . .
a
� .. „ � ., '_ , , �,�� �
. �, . . . . . .� . . , '
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0
rraa �cFEST�coriP
t JOBADDRESS C3O �7
GENERALCONTRACTOR S.E. McKee
LOT PP'� 116-200-I� BLOCN
GROUP 'J TVPE
INSPECTIONS I
Foundation Forms
Wiri
Final GasTest
I�orm 210 QH 1M 1&68
✓
BUILDING PERMIT NO. 2O6
� �VAWE $�.�ZOO.�O
TRACT Toilet Facilities
V ZONE M—�. FIRE DISTRICT # 2�.Z
� I SUBCONTRACTOR I PERMITSISSUED
L.OS a CSa lll I 1iCiiu '�� r�rri.ap�rslavL� r Vn i Law�u , �
(1 . • ' 1N EA6T 20th STREET p U I L��I� N G
�� �� �� }COSTA MESA, CALIFORNIA _ _.�—._ �..-- —_-------•----�= .
I F'OR AP�II.ICANT TO FILL IN + �OR OFF'ICE USE Ol\TLY _
'Rece�jipfNo:"— - Pe�m[�it /N .
Building /30 V� �7��Y STREa�T � 1 5 S O�� '1 ( �
� Address U •� . ,-. +
Costa Mesa, California Recei b a Date Rec'd. Date Issued �
� ty �� /� /�!' S
Nearost � .I
� � � � �_2� J �7 : / ��
Cross St. V up,c'2�o.0 i'+✓E Builtling 2� ,¢ �/!� ��
� Address �;i(J Lli• � 7 ' /j9 • ;
Owner�9,�G',�Sr C",�,,e,o ! Costa Mesa, CaGfornia .
Mail � � �
Addrcss��{�SCe.ro/ .(�e�+o. C;O. /y� Neacest � I
/i � Tel. Cros's St v,�v �r--�T f. �
Cityc.c'�ccwe ��G /��A2 No. —1 Zon'e�A � o.of ? Typ I Group�
Architeetor Lic. N/ � �I PIanS /� I �� � �
Engineer --' No. App�oved
— by , ! Date
Address �' COffiRECTIONS �
� / /� acY ���.GGZ �
Contrector�/.,�/�/�/��-"C No. °
Address ��7 J���A Aa• L'. D.�� � '
Legal I �ot I I .
Description No. Block TraCt , -
iHf !fl � c f v OB '
(Attach Metesand Bounds) �. .
� No. of Bldgs. G �
Sizeof Lot d y3op � I Nowon Lot _ __. __ ___� �
Use of I No. of I No. of �
Existing Bldg.�NOr�.ri.2ins. Families� Rooms . j�� �f�� �
Setback Line from i Rear Vard 22S _ _ - - �- Z
Center of Street s3 � Side Yard y
IDESCRIPIZON OF WORK .. � . � �- . �
New I �Alteretion I I Addition I " - � "� ' "' -" � ��'- ' "
nepair I ! Moving I I Demoiish I L,� �
�• Buildin No. of /
' � Size �2•B X 22-8 Rooms / Stories
Exterior Wal Rooi
Cevering_ � �L��I Covering �^+oa. APPRQ�7���''
Usr, of New
Building �A�'G�., Foundation Location Inspector Date
Forms, Materials,
' Under-Pinning
Frame: Fire Stops,
_ Bracing, Bolts
I hereby acknowledge that I have read this Application =ath. Int.
and state that the above is correct and agree to comply
with all City Ordinances and State Iaws regula[ing Lath. Ext.
building construction.
Signature oi Plaster, Int.
Permittee
,,o Plaster, Ext.
Authorized Agt. "� � �� �a-�
Masonry Relnforced
Valuation Permit Fee $ n
Plan Check $' O D Bond Beam �
ve,
a/ ���� Feeal $ G O FINA�
i�o��, xoa c-�i �nt �z-sx
y." .
�� . . _
. p, "' 1'',' ' '
C. O
J , c
� t6 i .. � ' n J i .
_L . a
a �
_ _ a
. '. c . . .
"S_ . .. ' � . �Y . . . _ . .' ;
, i
.. Q
Strcet
PLOT PLAN
Show Iowtion and distances irom
propeHy line and between buildings
(.,� ....... ....
. ' ' �
♦ i
' /�
�
n
1•
ER Mar Creat Corp.
JOBADDRE88
GENERALCONT
i•7.I7th
J.E.Mc %ee
LOT W�'2 AC�O� !}O8 BLOCi
GROUP S TVPE
INSPECTIONS
Footing Trench �
Foundation Forms and Grade to Garage
Rough Framing
Plumbing, Rough to Slab
Plumbing, Rough Complete
Temporary Pole
Wiring, Rnugh
Heating, Rough
Heating, Final
Sewer
Septic Tank or Cesspool
Lathing
I�lastering
Plumbing, Final, Fixtures Complete
Plu�nbing, Fi�l Gas Test
W iring, Final
Occupancy
Form 230 GN IM 12-68
TE 1
BUILDING PERMIT NO. �'1
VALUE $ 1�000.00
Masa Tract. „��
V ZONEMZ FIREDISTRICTAPP�7/'�i8
PERMITSISSUED
DATE SUBCONTRACTOR
i� DATE I NUMBI
� 4141.5 „ PAl1Joo �A¢
. „na i 2-�r,�„—;, E2s�=- 1 ZQ:63
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CAL�FORNIA 92626
P CA ION FOR STRUC7'URAL PERM[T
For Applicant to Fill in Completely — Use Ink Only
fiE I DATE RECEIVED
BUILDING � �
ADDRESS � /�
OWNER ♦{�y •�� f/Q C,QI ` � A.P.NO. II((7'� QO'O
MAIL / BUIIDING c
ADDRESS (O O �' � � � ADDFESS � � �,]
CITV '' M I NO. �W i ACTr _� Y LOT
CONSiflUCt10N ��
LENDER G�
BRANCH {�
OWNER • �. �J
ADDRESS VALUE
ARCHITECT r V�X -rtS TEL. S / � S
BR�£i�6{NG6A—�
FIqE
ADORESS � �� • �� 20NE /TVPE RO
APPROVE / _ �
CONTRACTOf± BV l/ DATE �
ADDFESS
TEL. ZONE - ftO.OF USE OF NE1�
CITV ' NO. � P�� BUILDING •
� STATE CITY �'ARDSAPPROVED VARD N
� LIC. NO. UC. NO. MAIN BUILDING ACCESSOR
{rJ SIZE NO.OF BLOGS. (FpOM GL 5T EET) �
0. OF LOT Q NOW ON LOT ONT �
� �sE oF � 6 ' �
EXIS7ING BLDG.
h
� Separa[e permits are required for L SID
o electric, plumbing and heating work. REAR Fr e�
QW USFyO�,B�ISJG�DJ{ilOFK TO BE PERFORMED
`L �� f= DISTANCE BET. BET. MAIN &
Q MAIN BLDGS. ACCESS. BLQ
a vl � VAq.9Y+ 0.4TE
� e � G.U.P.qW APPqpVED
� APGROVED
i' %� -/
a
a
w
� I hereby acknowletlBe ihat I hava reatl thia epplication end state
(� that the ebova Informailon is corract antl aprea to comply wlth
� nll lews requletlnp EulldinB consttueNon, end I shall not employ
z any oerwn In vlolation of the workman's compenaatlon lewa of
Tthe State of Callfornla.
3 1 hereby certify chet I am propariy Ilcensed as a conaeccor under S�. FT.
tho Stata oi Californla Businav and Professione Code, Dlvislan 3, THE AMOUNT SMOWN UNDE V U
Chapier 9, ontl that sue� Iieenms ere In full torea and etfect, or I THE PUFiPOSE OF EST fil
em exampt from the provlsions of Me Stete ot California Busineu VALUATION PERMIT FEE
antl Profosslons Cotla, Dlvision 3, Chepter 9, �7 �
Sipnaturo of // �I PLAN CHECK S
Permittee g ���/�'Jr'n
� '/ /� V V TAX S
Authorizad Apent ,�.L / V�' ��.cp TOTAL PAI D E
n
m
i
m
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m
b
N
m
n
0
LL
g
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r
1f �.a
�- 1�4�34
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA, CALIFORNIA
For Applieanf io Fill In Complefely
TYPE OR PRINT
BUILDING 63� W� 1'lth
ADPRE88
COSTA MESA CALIFORNIA
■ MAIL
TEL.
9�(1 l. t
No. OP eLD08.
LINB PqOM
�F BTrtEeT „ 3� t REAR YAR[
RD I LEFT I RIGHT
DESCRIPTION OF WORK
A�I�fl'_'I�r e°;,3�
oP BU'.
�
FIRE
zorve
�eow�
���E R�.����1�.0
' maR a »si
� FINAI�CE DEPT.
CITY OF COSTA f�ESA
APPLICATION FOR PERMIT
BUILDING
For O#ice Use Oniy
HBCHIPT NO. PPqFyT NO
C05TA MESA. CALIFORNIA
T/Y�PE ' GROUP
�/' AT
ZONING �
e+o. ov use or New
runs emi.nirvo
�%�fi�z'=�i��i..
i/!n� � IiLri _ Lo
1 HRRBBY ACKNOWLeD08 THAT � XAVB RBAO THI6 APPUGTION TX6 AMOUM BHOWN UNOBR YALUALLON 19 POR TH¢
ANC BTATE TIiAT TX6 A90V8 IB CORIiECT AND AOq68 TO COM• pURPOBE OP 69TABLIBHINO A vHRMIT iE¢ ONLY.
PLY WITH ALL CIiY ORDINANG89 AND eTATB LAW9 6HOULATNa
Bu1W1Na CowernucilON. (�/ VALUATON �J
SIGNATURE O j` � � �, /� PERMIT FEE $ OC �
PERM�7TE �
' _ �
$ � r PLAN CHECK $ ��
AUTHORIZED ACENT d\ � ��
TOTAL FEE
� � � FEE RECEIVED
- �_�?wo
COSTA MESA BUILDING-SAFETY DEPARTMENT @�w
P. O. BOX 917 C06TA MEBA. CALIPORNIA �����R SO�� O L�
N�;�
For Applicanf +o Fill In CompletelY APPLIC�iIfY�IS�FF�B$PkR�HSA
TYPE OR PRINT BUILDING
BUILDING r.'
ADDRE88 W � ��"
COSTA MESA. CALIFORNIA For Offite Use Only
/ / /i n aecs�rr No. re$y � No�
OWNER C ZS �'O I` • /`7'T,�L G
MAIL /� AN� /� VL R6G61VED BY OA*g PBGIIIVHQ'/ ,9� T8 188U6D
AODRE55 L�1 �7 L %C� I 7'� `7 �< I y'-S�'� G j
TEL. 3. S BUILDING �'l� /'� . i./ _ �%
CITY NO. ADDRESB ��� «� �
ARCHITECT T COSTA MESA. CALIFORNIA
OR ENGINEER
A�DRE83 \ �� PIRE ��
ZONE TYPE GROUP
� �� .> APPROVED {•//,� S'G /
CONTRACTOR _ BY ATE "/
ADDRESS �' Z � ING � �j /J
�^ ZONE I NO. OP I U98 OP NEW I
CITY C I/_1 ' ! � PtwHe � BUltol �
BTATE � '� TEL. � �(�7 •
LIC. NO. NO. DeeCRI ION � i• A
OP LOT �' •/' �� V f I NOW ON LdfO6• � /� � �/ O� O =F 'c•
A. P. NO.
E7(IBTING BLDG d T� C VARDB EVE6
APPROVED ALLOWED
8t}BACK LIN6 PROM (�MT�A YN6 ST.) �• �
CENT6R OP eTteeT REAR YARI
81DE YARD I LEPT • I RIGHT
DESCRIPTION OF WORK
REAR �
APPROVHD /�,
g,Z,E�NG , ` ' Q�ROOM6 � STOB
EXTERIOR WALL� ROOF
COVHRING .ICOVERING
USE OP BUILDIN AND WORK TO BE PERFORMED
iN
' IN. _
:� � /
1 NBPEBY ACKNOWLlD6H THAT � XAVE NGD TXIB APPLIGTION THE AMOUM 6HOWN UNDEF VALUATION 19 POR THe
•ND BTAT6 THAT THE ABOVE (B COMBCT AND AORlB TO COM- pUqPp6¢ OP E6TABLIBHINp A PERMIi PE¢ ONLY.
PLY WITH ALL CIiY ORDINANCEB AND 6TAT[ LAWs pgOULATINO
BUItnINo coNeirturnox. � VALUATION
SIGNATURE OF � � PERMIT FEE $ �
PERMI7TE ' � X a
��j£�! 4�+-B-GYLi S DO PLAN GHECK S -- '
AUTHORIZED AGENT C
TOTAL REE y
a g e ar�menz
' 111 EABT 20th STREET
' COSTA MESA� CALIFORNIA
FOR APPLICANT TO b'II.L IN
Bullding
Addreas 6�'j� W i
Costa Mesa, California
IAddress
Contrae
Address
'Size oT lM
Use of
Existinp B
Bullding
81ze F
Exterior W;
Covering
Use of New
Tel.
No. HA _ l R'
Lic.
r.t No.t.Ta_�i
St
City Llo.
No.
fl St _
Biock � Tract
�f'll%/6 -a��-
INo. of Bldga
Now on Lot F
� � Alteration
Roof
Additfon
I hemby acknowledge that I have read this Application
and state that the above is crorrect and agree to comply
with all Clty Os'dinances and State laws regulating
building construction.
Sfgnatureof '� � �
Permittee 7
� '
Authorized Agt. � ��
i i
AYYLiutirxr� r �ic rr.is�i�u� �
�6 BUI.LDING
- FOR OF'FICE USE ONLY
Rece(pt No. Permlt No.
a3z�
Received by Date Rec'd. DaM Issued
�� �-3-5 (o o�-3-J G
Building
Address
Costa Mesa, California
Nearest
Cross St.
Zone No. of Type Group
M/ I Plans %%l
nrr�ovnr�
Foundation Loeation Inspectar Data
Forms, Materlals,
Under-Pinning �
Frame: Fire Stops,
Bracing, Bolts
Lath. Int
Valuation / Peemit Fee $ a.0 � Masonry Rei
Plan Check $ �
$ / D � Total Bond Beam
$ a. �-
Fee FINAL
FORM 204 S-HP 2M 6-55
i
PLO� PLAN
Show location and disYances from
. _ property Iine and between buildingx
c
6
/do; � . .. .
FfG-.G-SSPD�Es,�C 7.5a �`•fit'•�2,(!O
r - �
. ._ . i � � .
�
� (;asta Mesa Buwlding llepartment
, 111 EAST 20th STREET
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
aaadress 6 W 7
Costa Mesa, California
■ Address
Metes
New
Y Use
Tel.
No.HA _ 1 9R4
Lfc.
No. T.TR_� � 4
3 t. .
City Llo.
N0.
ir. �
i
:k I Traet
����^ "00'
No. of Bldga
Now on Lot rj
No.ot No.oT
Familles Rooma
Rear Vard L�
Sida Vard � �j
�F �VORH
II Addltion I X
II Demolish I
?PLICATION r'utc rr:nivu'�
BUILDiNG
FOR OFFICE USE ONLY
� Receipt No. � Permit N
I I a3��
Recelved by Dale Redd. DaM Issue
�.-r� � ,� 3 -:i � .� - 3 - J"
Buflding
Address
Costa Mesa, California
Nearest
Croa St. �
Zone /� No. of Type Group .
N/ � I Plans � �
Frame: Ffre Stops,
Bracing, Bolts
I hemby admowledge that I have read this Applicatlon
and state that the above is correct and agree to comply Lath. Int
with all CYty Orciinances and State Iaws regulating
building construction. Lath. Ext
Signatureo e%C/L� . �� �.
Permittee Plaster, Int
AuthoHzed Agt. !i/ — Plaster, Ext
Valuati0n Permi Fee $ o� -� 0 Mawnry ReinTorced
� Plan Check $
$ � b �� Total Bc
Fee $ o�. � d F�
FORM 204 S-BP 2M 655 '
•��:�.
Ai C
Data
1 LV 1 1 LCal�
Show Iowtion and distances from
property Iine and between buildings
. � 27805
C05TA MESA BUILDING-SAFETY DEPARTMEPR
P.O. BOX 72fN COSTA MESA� CALIFORNIA 92020 .
Fo� Applimnt ro Fill In Complohly
TYpE OR PRINT
YUILDINO T
AOOR6YII 3O W 1 N ��
COSTA MESA. CALIFORNIA
nicnv[
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euao�na
ADDR � 3O W� `1 � S 1 • ADDR
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ARCMITECT �U���� NQ{�4�'�+I ByPROV6L
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ADDRBYY ZA IJ :1VE,.K:]S I-�I�SA ZON�
MfRA` ����� � ' 1'/
CO
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AODR � �ce�nlo
CITY A. P. NO.
eTAT6 TEL. ' N0T8: NO
80' TO 811
LIC. NO. N .
EAVEB
S12H I NO.OIetDo�. ALLOWED
PF LOT NOW oN LOT
YARDL
USE OF u.�.�
PhI'C �..,
�7c::=(0� SP, .. .. •?i ,'1�
FOR PERMR
IIN6
UH Only
� NO.
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NEW T6MTION ADDITION R�R �' Z ��
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REPAIR M VINO DCMOLI H MAIN BLDOB. / AGCE89.BLDOB.
BUILDINO NO.OP VAR.� DATfi
8IZ8 ROOM9 BTpRIRH C. . APPROVHD
eXTERIOR WALL ROOP /1r�ROV[D �// �//q� (� /�/
COVHRINO COVERINO LG'atG�l�%+:.. GATi��� �/ rtl /
UYi OF EUILDIqY AND WOR TO 86 PBRPORM[D � V" p,
�oi �.2 S 2 m
.51�@S� Ati O ' �a,
eo. rr. �
I X[R6SY ACKNOWLtDOt TXAT.1 MAV[ Rfl1p 11��� AypV WTON TXG AMOYM fMOWl1 UNO[P VALUATON IB POR iN8 �
AND BT�TC THAT iM[ AlOVi I8 CORR[R ANO AOR6f YO CAY• ��APoe[ 01� tlTAlYBHINO A P6PYIT /Hi ONLT. �
PLY WITN �LL CITY OROINANCH� AIIO OTA}{ IA1N� R[YYIATINY yAW/+TIOP1 a
OYILDING CONeTNUCiION. �
816NATURlO� Q� PBRMITFEB �O �
PHRMITTH s �Q L�Q rRO W
j � /� J • v
AUTXOPIZ[DAGiNp U,C.Cdl.(,�,�. q 'OO
TOT�tL PEE L
. �� 27991
COSTA MESA BUILDING-SAFETY DEPARTMENf
P.O. BOX 1P00 � COSTA MESA� CALIFORNIA Y2646
Fo� Appllcanf fo FIII In Wmpleroly
TYPE OR PRINT�/.
BVILDINO t`�
ADDRE38 / i /� �
COSTA MESA, CALIFORNIA
■ MAIL
@TAT6
LIC. NO
s�ze
OPLOT
USE OP
TH4 �
DESCRIPTION OP WORK
NO.Or
ROOMH
WALL ROOP
COVBP
9LUItlY AND WORK TO O6
�—
1 H6R6BY ACRNOWL6DOi �TMA} � NAV[ RHAD TXI!
I1HD 6TAT8 TNAT TX6 AGOV6 1� CORp6CT�AND AO
PLY WITH �LL CITY OqD1IU 1[/ AND iT11II W9
GUILDINO CONBiRY�I(Qj C
BIGNATURE OP
P8RMITTH
AYTHOIIIZiD A NT
� , ■ tiaw�
�-s�00 2se ��**�33.00
APPLICATION FOR PERMR
BUILDINf3
For Offlce Uss Only
R[C[IR NO. RRq(�.I
L I JJ
r / � L/ �/ Y / n��e/ ��
ZONING �1�
MO.OI UY[O!N[W
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Y
�¢OV[RMAN68HALL�6 TNAN
i RBAR P. L
(U..B.G_$lCUIR6MENT1
YARGOMPROVHD YARDSAPPROVHD
MAIN BUILDINO ACCED80RY BUILOINO
van.ai owre
C. U. P. MPROV6D
MPROV[D /� _'__ " /.
�� � a
�
�
�.�. �
TX[ AMOUNT eMOWN UND[R VALUATON 19 IOq TH6 j
�YHPoO6 OP iBTAGLIBNINO A P6RM�T I88 ONLY. A
VALUATION �,'_ �
� PHRMITP88 ✓J p
C
%W
O/ � 0 Q � 73�
TOTALFHB